scholarly journals Epidural lipomatosis in elderly patient: A rare cause of cauda equina compression

2021 ◽  
Vol 12 ◽  
pp. 7
Author(s):  
Abiodun Idowu Okunlola ◽  
Tesleem Olayinka Orewole ◽  
Cecilia Kehinde Okunlola ◽  
Olakunle Fatai Babalola ◽  
Akinola Akinmade
Keyword(s):  
Spinal Stenosis ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
The Elderly ◽  
Neurogenic Claudication ◽  
Epidural Lipomatosis ◽  
Cauda Equina Compression ◽  
Epidural Fat ◽  
Magnetic Resonance Imaging Mri ◽  
Lumbar Spinal

Background: The most common cause of cauda equina compression in the elderly is lumbar spinal stenosis. Epidural lipomatosis is an additional known but rare cause of cauda equina compression readily diagnosed on MR studies. Notably, spinal canal decompression and direct excision of the epidural fat effectively manage this combined pathology. Case Description: A 70-year-old male presented with progressive truncal obesity associated with refractory lumbar neurogenic claudication. The lumbar magnetic resonance imaging (MRI) showed excessive epidural fat extending from L4 to S2 resulting in thecal sac compression; this was confirmed on the MRI myelogram study. Following a decompressive laminectomy, the patient’s cauda equina syndrome resolved. Conclusion: Recent weight gain with increased neurogenic claudication and the onset of a cauda equina syndrome may herald the presence of significant lumbar epidural lipomatosis. Here, laminectomy for excision of the excessive epidural fat resolved the patient’s symptomatic spinal stenosis.

Lumbar Neurogenic Claudication

2018 ◽  
Author(s):  
Raj J. Gala ◽  
James Yue
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
The Elderly ◽  
Clinical Syndrome ◽  
Neurogenic Claudication ◽  
Epidural Steroid Injections ◽  
Magnetic Resonance Imaging Mri ◽  
Asymptomatic Individuals ◽  
Lumbar Spinal ◽  
Epidural Steroid

Lumbar neurogenic claudication, sometimes referred to as pseudoclaudication, is the clinical syndrome of back pain radiating down one or both legs during ambulation. Classically, the symptoms abate with forward flexion of the lumbar spine and worsen with extension. The condition arises from lumbar spinal stenosis, which is common in the elderly population. Many asymptomatic individuals have lumbar spinal stenosis seen on magnetic resonance imaging (MRI), so this syndrome is a clinical diagnosis. The majority of patients have favorable responses with conservative treatment, which includes physical therapy, bracing, medications, and epidural steroid injections. Patients who do not improve may go on to have surgery. Spinal stenosis has become one of the most common reasons to undergo lumbar spinal surgery in patients older than 65 years of age.

scholarly journals Stuburo juosmeninės dalies kanalo stenozė: klinikinė anatomija, diagnostika (I dalis)

2003 ◽  
Vol 1 (4) ◽  
pp. 0-0
Author(s):  
Valentinas Uvarovas ◽  
Giedrius Kvederas ◽  
Igoris Šatkauskas
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Nerve Root ◽  
Cauda Equina ◽  
Neurogenic Claudication ◽  
Clinical Anatomy ◽  
Ageing Population ◽  
Imaging Studies ◽  
Pathologic Features ◽  
Lumbar Spinal

Valentinas Uvarovas, Giedrius Kvederas, Igoris ŠatkauskasVilniaus universiteto Ortopedijos, traumatologijos ir plastinės chirurgijos klinikaVilniaus greitosios pagalbos universitetinė ligoninėŠiltnamių g. 29, LT-2043 VilniusEl paštas: [email protected] Pasaulyje ženkliai auga pagyvenusių žmonių populiacija, kartu daugėja ligų, kuriomis dažniausiai sergama perkopus į antrą gyvenimo pusę. Viena iš tokių ligų yra stuburo kanalo stenozė, t. y. susiaurėjimas. Dažniausia stuburo kanalo stenozės priežastis yra su amžiumi progresuojantys stuburo degeneraciniai pokyčiai. Ne visada arklio uodegos ar nervų šaknelių spaudimas sukelia dirginimo simptomus, tačiau progresuojant patologiniams anatominiams ir fiziologiniams pokyčiams gali išryškėti klinika. Kartais rentgenologiniai duomenys neatspindi klinikos, todėl labai svarbu tiksliai įvertinti ligos simptomus, jų eigą bei rentgenologinius duomenis, kad būtų pasirinkta tinkama gydymo taktika. Prasminai žodžiai: stuburo kanalo stenozė, neurogeninė klaudikacija, nervinės šaknelės, arklio uodega Lumbar spinal stenosis: clinical anatomy, diagnostics Valentinas Uvarovas, Giedrius Kvederas, Igoris Šatkauskas Lumbar spinal stenosis remains one of the most frequently encountered clinical important degenerative spinal disorders in the ageing population. Spinal stenosis is a narrowing or stricture of the spinal canal. Cauda equina and nerve root compression are noted in many asymptomatic individuals. The spinal degenerative process associated with ageing leads to pathoanatomical and pathophysiological changes with occasional clinical consequences. With progressive degenerative changes and compression, spinal stenosis may become symptomatic, although the severity of the symptoms is not necessarily associated with the magnitude of the compression seen on imaging studies. A thorough understanding of the etiology, pathologic features and a correlation between the symptoms and the precise location of the thecal sac and nerve root are very important in evaluating the imaging studies and planning appropriate treatment. Keywords: lumbar spinal stenosis, neurogenic claudication, spinal nerve root, cauda equina

scholarly journals Cauda equina syndrome without motor dysfunction following lumbar spinal stenosis surgery

Medicine ◽  
2019 ◽  
Vol 98 (29) ◽  
pp. e16396
Author(s):  
Tianyang Yuan ◽  
Jun Zhang ◽  
Lili Yang ◽  
Jiuping Wu ◽  
Haiqing Tian ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Motor Dysfunction ◽  
Lumbar Spinal

scholarly journals Simvastatin Ameliorates Cauda Equina Compression Injury in a Rat Model of Lumbar Spinal Stenosis

2012 ◽  
Vol 8 (1) ◽  
pp. 274-286 ◽  
Author(s):  
Anandakumar Shunmugavel ◽  
Marcus M. Martin ◽  
Mushfiquddin Khan ◽  
Anne G. Copay ◽  
Brian R. Subach ◽  
...  
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Rat Model ◽  
Cauda Equina ◽  
Compression Injury ◽  
Cauda Equina Compression ◽  
Lumbar Spinal

Decompression of Lumbar Spinal Stenosis and Stabilization with Knodt Rods in the Elderly Patient

Neurosurgery ◽  
1990 ◽  
Vol 26 (5) ◽  
pp. 758-763 ◽  
Author(s):  
Frances K. Conley ◽  
Carol T. Cady ◽  
Robert E. Lieberson
Keyword(s):  
Elderly Patient ◽  
Spinal Stenosis ◽  
Signs And Symptoms ◽  
The Elderly ◽  
Long Term Results ◽  
Neurogenic Claudication ◽  
Stabilization Procedure ◽  
Lumbar Spinal ◽  
Spine Fixation

Abstract We present a series of 25 elderly patients who exhibited signs and symptoms of neurogenic claudication and who were found to have one or two levels of spinal stenosis. At the time of decompressive surgery, excessive movement was found at the stenotic levels, so a simple stabilization procedure was performed using Knodt rods and a facet fusion. The expectation was that spine fixation would decrease the amount of postoperative back pain, which can be a result of continued abnormal mobility. All of the patients have been followed for 2 or more years. This elderly group of individuals tolerated surgery well, and long-term results were good.

scholarly journals Cauda equina syndrome secondary to lumbar disc herniation. Report of three cases

2013 ◽  
Vol 20 (3) ◽  
pp. 261-266
Author(s):  
Danil Adam ◽  
Ioana Hornea
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Surgical Decompression ◽  
Pathophysiological Mechanism ◽  
Lumbar Intervertebral Disc ◽  
Maximum Improvement ◽  
Lumbar Spinal

Abstract Cauda equina syndrome produced by the herniated lumbar intervertebral disc is a rare disorder that, if is undiagnosed and untreated in time, can have serious consequences for the patient and medicolegal implications for the surgeon. We report the clinical evolution of 3 patients with lumbar spinal stenosis who still present sphincterian and sexual dysfunctions many years after surgery, even if they were operated on immediately after admission. Reviewing the literature on this subject has allowed us to emphasize symptomes, pathophysiological mechanism and management regarding patients with lumbar spinal stenosis. The surgical decompression is indicated as soon as possible. The surgical decompression within 48 hours from onset allows maximum improvement of symptoms and absolves the surgeon of any medico-legal liability

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