scholarly journals Dorsal extrusion of intervertebral disc as a cause of cauda equina syndrome

2011 ◽  
Vol 64 (7-8) ◽  
pp. 419-421
Author(s):  
Aldin Jusic ◽  
Rasim Skomorac ◽  
Hakija Beculic
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Intervertebral Disc ◽  
Urinary Retention ◽  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Good Recovery ◽  
Resonance Imaging ◽  
Extradural Space

We have presented a case of rare dorsally sequestrated lumbar disc herniation manifesting as cauda equina syndrome. The patient was admitted to the Neurological Department of Canton Hospital Zenica due to urinary retention and weakness in both lower extremities. Magnetic resonance imaging showed a compressing mass located in the dorsal extradural space at the L2- L3 level. An extruded intervertebral disc was found intraoperatively. The decompression was followed by good recovery.

Posterior epidural migration of a lumbar disc fragment: a series of 6 cases

2011 ◽  
Vol 15 (1) ◽  
pp. 117-128 ◽  
Author(s):  
Ali Akhaddar ◽  
Abad El-asri ◽  
Mohammed Boucetta
Keyword(s):  
Magnetic Resonance Imaging ◽  
Systematic Review ◽  
Magnetic Resonance ◽  
Intervertebral Disc ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Case Series ◽  
Review Of The Literature ◽  
Resonance Imaging ◽  
Lumbar Intervertebral Disc

Object The migration of a lumbar intervertebral disc fragment to the posterior epidural space is a rare complication of lumbar disc herniation (LDH), mostly diagnosed intraoperatively. The authors describe a series of 6 patients with a posterior epidural migration of a lumbar intervertebral disc fragment (PEMLIF) and provide a systematic review of the literature. Methods The authors undertook a retrospective case series of patients with PEMLIF who underwent surgery for LDH between February 2007 and June 2010. In 6 (1.04%) of 572 patients a diagnosis of PEMLIF was established. In addition, a systematic review of the literature produced 41 additional cases reported since 1973. The authors analyzed epidemiological, clinical, and imaging features, as well as surgical treatment and outcome of this infrequent form of LDH. Results This study represents the largest case series to analyze the distinguishing features of PEMLIF. Including the authors' cases, 37 male (78.72%) and 10 female (21.28%) patients (mean age 54.08 years) appear in the literature. Although the predominant clinical disturbance was related to cauda equina compression in 22 patients (46.80%), 19 patients (40.42%) presented with typical symptoms of sciatica or anterior thigh pain. In 27 patients (57.44%), PEMLIFs were localized at high lumbar levels. Magnetic resonance imaging was used in 36 cases. The PEMLIF appeared iso- to hypointense on T1-weighted imaging and had a variable intensity on T2-weighted imaging. After administration of Gd, 85.71% of lesions exhibited a peripheral ring. The preoperative diagnosis was never related to PEMLIF in 68% of cases. The PEMLIF was totally resected in all patients. An additional discectomy was performed in 31 patients (65.95%). Information was incomplete in 1 case. Of the remaining 46 patients, all improved postoperatively: total recovery was achieved in 33 cases (71.74%), subtotal recovery in 2 cases (4.35%), and improvement in 11 cases (23.91%). The postoperative outcome appeared not to depend on the duration or the degree of preoperative neurological deficits or the size of disc fragment. Conclusions The migration of a lumbar intervertebral disc fragment to the posterior epidural space is a rare event, occurring in an advanced working-age population. Clinical presentation is indistinguishable from the typical LDH, but overall cauda equina symptoms are far more common. High lumbar levels are more affected. Magnetic resonance imaging characteristics are difficult to differentiate from those of other entities. Ring enhancement after Gd administration is common. Outcomes in patients with cauda equina symptoms appear better than those in patients with standard ventral compression.

scholarly journals Cauda Equina Syndrome-Induced Acute Urinary Retention in Patients with Acute Lumbar Disc Herniation: Report of Two Clinical Cases.

2020 ◽  
Author(s):  
Hoai Thi Phuong Dinh ◽  
Hai Minh Nguyen ◽  
Duyen Nha Le ◽  
Anh Thi Quy Le ◽  
Minh Thanh Nguyen ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Urinary Retention ◽  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Acute Urinary Retention ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Neurological Dysfunction ◽  
Resonance Imaging

Abstract Objective: to discuss two cases with CES-induced acute urinary retention, knowledge of which is essential for early diagnosis, treatment and prevention of neurological dysfunctions. Case presentation: Two patients were hospitalized with symptoms lower back pain with weakness and progressive loss of feeling of lower limbs accompanied by acute urinary retention, urinary system tests were within normal limits. Magnetic resonance imaging results in lumbar disc herniation causing spinal stenosis. Both patients underwent posterior lumbar interbody fusion (PLIF) procedure and showed improvements in symptoms after surgery and re-examination.Conclusion: The diagnosis should be based on magnetic resonance imaging. Lumbar disc herniation is the most common cause of acute urinary retention from cauda equina compression. Laminectomy, with early decompression within 24 to 48 hours, reduces the risk of long-term neurological dysfunction and increases the chances of recovery for the patient.

When infection mimics cauda equina syndrome: a cautionary tale

2021 ◽  
Vol 103 (6) ◽  
pp. e181-e183
Author(s):  
R Shah ◽  
N Jayakumar ◽  
S Athar ◽  
N Ashwood
Keyword(s):  
Magnetic Resonance Imaging ◽  
Cerebrospinal Fluid ◽  
Magnetic Resonance ◽  
Varicella Zoster Virus ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Lessons Learned ◽  
Resonance Imaging ◽  
Varicella Zoster ◽  
Elsberg Syndrome

A 63-year-old man presented to the emergency department with low back pain, perineal and genital numbness, together with bilateral lower limb paraesthesia and urinary retention. He was admitted under the orthopaedic service for investigation of suspected cauda equina syndrome. Magnetic resonance imaging of his spine did not reveal any evidence of cauda equina compression. Magnetic resonance imaging of his brain demonstrated nonspecific multiple hyperintensities in the right frontotemporal and left temporo-occipital regions. Computed tomography of his chest, abdomen, and pelvis did not identify any evidence of malignancy. Cerebrospinal fluid from a lumbar puncture showed a high leucocyte count (predominantly lymphocytes). Viral cerebrospinal fluid polymerase chain reaction was positive for varicella zoster virus. A diagnosis of varicella zoster virus myeloradiculitis (Elsberg syndrome) was established and the patient was treated with intravenous aciclovir. Unfortunately, the patient succumbed to a devastating intracerebral haemorrhage during his inpatient stay, probably due to vasculopathy from the underlying varicella zoster virus infection. This case describes a rare infectious mimic of cauda equina syndrome. Elsberg syndrome is an infectious syndrome characterised by bilateral lumbosacral myeloradiculitis, with varicella zoster virus being a well-recognised aetiological agent. We discuss the relevant literature in detail and identify the key, cautionary lessons learned from this case.

Magnetic Resonance Imaging of Cauda Equina Syndrome in Ankylosing Spondylitis: A Case Report

1995 ◽  
Vol 5 (1) ◽  
pp. 46-48 ◽  
Author(s):  
Robert A. Koenigsberg ◽  
Jonathan Klahr ◽  
Joseph L. Zito ◽  
Mahendra Patel ◽  
Steven Carsons
Keyword(s):  
Magnetic Resonance Imaging ◽  
Case Report ◽  
Ankylosing Spondylitis ◽  
Magnetic Resonance ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Resonance Imaging

Prevalence of thoracic spine lesions masquerading as cauda equina syndrome: yield of a novel magnetic resonance imaging protocol

2016 ◽  
Vol 12 (8) ◽  
pp. 1259-1264
Author(s):  
Katherine Stolper ◽  
James Clark Haug ◽  
Chad Todd Christensen ◽  
Kathleen Michelle Samsey ◽  
Michael David April
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Thoracic Spine ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Resonance Imaging ◽  
Imaging Protocol ◽  
Magnetic Resonance Imaging Protocol

scholarly journals Acute Cauda Equina Syndrome Secondary to a Lumbar Synovial Cyst

2012 ◽  
Vol 5;15 (5;9) ◽  
pp. 435-440
Author(s):  
Jeffery J. Muir
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Synovial Cyst ◽  
Herniated Disc ◽  
Resonance Imaging ◽  
Residual Symptom ◽  
Unsuccessful Attempt ◽  
Synovial Cysts

Cauda equina syndrome is a well described state of neurologic compromise due to lumbosacral root compression. In most cases, it is due to a herniated disc, tumor, infection, or hematoma. We report a case of rapid lumbar synovial cyst expansion leading to acute cauda equina syndrome and compare it to similar cases in the literature. The patient is a 49-year-old woman with a history of chronic low back pain who developed cauda equina syndrome. Serial lumbar magnetic resonance imaging studies demonstrated a significant increase in the size of a lumbar synovial cyst over a 2 week interval. After an unsuccessful attempt to relieve her acute symptoms with computed tomography-guided cyst aspiration, an L4-5 posterior spinal decompression with excision of the synovial cyst was performed. Postoperatively the patient’s perineal numbness, bladder incontinence, and associated pain complaints resolved. The only residual symptom at one month follow-up was continued numbness in the right lower limb in an L5 distribution. This report adds to 6 other well described similar cases found in the literature by illustrating several important points. First, a lumbar synovial cyst is a rare but possible cause of acute cauda equina syndrome. Second, magnetic resonance imaging is the test of choice to diagnose and characterize lumbar synovial cysts; serial imaging can detect fluctuations in cyst size. Third, percutaneous treatment of lumbar synovial cysts is variable in efficacy and proved to be unsuccessful in our patient. Finally, surgical management has shown high success rates for symptomatic cysts. Specifically, in the setting of acute cauda equina syndrome secondary to a lumbar synovial cyst, urgent surgical decompression has led to resolution of neurologic symptoms in most reported cases. A lumbar synovial cyst is an uncommon cause of acute cauda equina syndrome. Prompt diagnosis and treatment may lead to reduced morbidity associated with this condition. Key words: Acute pain, cauda equina syndrome, lumbar, polyradiculopathy, synovial cyst, zygapophyseal joint

scholarly journals Cauda equina syndrome caused by filum terminale lipoma: magnetic resonance imaging features and surgical treatment

2017 ◽  
Vol 15 (1) ◽  
pp. 114-114
Author(s):  
Benedito Jamilson Araújo Pereira ◽  
Ulysses Caus Batista ◽  
Fúlvio Nicolau Bechelli Filho ◽  
Carlos Alberto Afonso Ribeiro ◽  
Carlos Vanderlei Medeiros de Holanda ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Surgical Treatment ◽  
Magnetic Resonance ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Imaging Features ◽  
Filum Terminale ◽  
Resonance Imaging

TRANSIENT SYRINGOMYELIA LEADING TO ACUTE NEUROLOGICAL DETERIORATION AFTER REPAIR OF A LIPOMYELOMENINGOCELE

Neurosurgery ◽  
2007 ◽  
Vol 61 (2) ◽  
pp. E426-E426 ◽  
Author(s):  
Nicholas H. Post ◽  
Jeffrey H. Wisoff ◽  
Charles H. Thorne ◽  
Howard L. Weiner
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Motor Function ◽  
Postoperative Period ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Magnetic Resonance Imaging Scan ◽  
Resonance Imaging ◽  
Lumbosacral Region ◽  
Resonance Imaging Scan

Abstract OBJECTIVE Transient paraplegia in the immediate postoperative period after lipomyelomeningocele repair is uncommon and is not discussed in the literature. We present the unique case of a patient who developed transient paraplegia 48 hours after lipomyelomeningocele repair attributable to the acute development of a thoracic syrinx. CLINICAL PRESENTATIOn At birth, the patient was noted to have a large skin-covered mass in the lumbosacral region. On neurological examination, both iliopsoas and quadriceps exhibited 3/5 motor function, and the plantar flexors and dorsiflexors exhibited 1/5 motor function. Urodynamic studies were normal. Magnetic resonance imaging demonstrated the presence of a lipomyelomeningocele associated with tethering of the spinal cord in the lumbosacral region. INTERVENTION At 5 months of age, the patient underwent repair of the lipomyelomeningocele. After surgery, the patient developed progressive paraplegia along with bowel and bladder dysfunction. Given the concern about a postoperative hematoma resulting in cauda equina syndrome, the patient returned to the operating room for a wound exploration. No compressive lesion such as a hematoma was found at surgery. A postoperative magnetic resonance imaging scan obtained afterward, however, demonstrated the presence of a large thoracic syrinx. CONCLUSION Syrinx formation can occur as early as 48 hours after lipomyelomeningocele repair, leading to progressive lower extremity weakness and bowel and bladder incontinence. In the immediate postoperative period, an acute syrinx can mimic cauda equina syndrome, and a magnetic resonance imaging scan is necessary to distinguish between these two entities. In this patient, the syrinx was transient and resolved without a shunting procedure.

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