SciCombinator

Discover the most talked about and latest scientific content & concepts.

Concept: Cauda equina syndrome

0

Penetrating spinal injuries by wood are infrequently reported. They are particularly rare in children. Only 6 cases of wooden fragments causing penetrating intradural spinal injury have been reported. The authors report a case of a 3-year-old girl who suffered a penetrating wound on her lower back after sliding on a wood floor. A portion of the extraspinal part of the wooden splinter was removed prior to presentation; however, a high suspicion for retained foreign body was maintained. Findings on CT were equivocal, but the diagnosis was confirmed on MRI. An incomplete cauda equina syndrome was noted on examination. She was taken to the operating room for removal of the wooden foreign body, repair of a durotomy, and repair of a CSF leak. At 8 months after surgery, the patient had fully recovered without sequelae. The roles of imaging modalities, prophylactic antibiotics, and surgery are discussed.

Concepts: Paraplegia, Cauda equina syndrome, Physician, Injuries, Medicine, Injury, Surgery, Cauda equina

0

Timing of surgery and the importance of the size of disc prolapse in cauda equina syndrome (CES) remain controversial.

Concepts: Spinal disc herniation, Hernia, Prolapse, Cauda equina syndrome, Surgery, Cauda equina

0

Endovascular therapy has proven to be a safe, minimally invasive treatment for multiple etiologies, but proper precautions must be taken to avoid complications. When complications occur, they should be promptly identified and corrected when possible. This case report describes endovascular stents misplaced into the epidural spinous venous plexus rather than the iliofemoral arteries, causing cauda equina syndrome, as well as the spinal procedure performed to treat the resulting spinal canal compression.

Concepts: Stent, Invasiveness of surgical procedures, Medicine, Open surgery, Minimally invasive, Epidural space, Cauda equina syndrome, Cauda equina

0

When a dural defect is encountered during spine surgery, the dura mater must be reconstituted to minimize the occurrence of minor or major life-threatening sequelae. The neurosurgical literature lacks strategies for managing large dural defects encountered during surgery. The authors describe a 24-year-old man who developed cauda equina syndrome secondary to altered CSF flow in a large thoracolumbar arachnoid cyst. Surgical decompression and fenestration of the arachnoid cyst were performed, and the large dural defect was treated using a multilayer closure with collagen matrix, titanium mesh, and methylmethacrylate. At his 24-month postoperative follow-up, the patient had recovered full strength in his legs, and his sensory deficits and sexual dysfunction had resolved. His incision had healed well, and there were no signs of pseudomeningocele. He had no additional positional headaches. The defect was managed effectively with this technique. Although this technique is not a first-line strategy for dural closure in the spine, it can be considered in challenging cases when large dural defects are not amenable to traditional closure techniques.

Concepts: Cauda equina syndrome, Meninges, Cerebrospinal fluid, Subdural hematoma, Collagen, Spinal cord, Cauda equina, Dura mater

0

Objective: To explore the correlation between the spinal nerve high tension and lumbar disc degeneration, the pathogenesis of hanging intervertebral disc degeneration. Methods: From June 2016 to June , a retrospective analysis 2017 of 100 cases of lumbar spinal stenosis were included in Department of Spine Surgery, Changzheng Hospital, the Second Military Medical University. They were divided into experimental group (50 cases, nerve high tension group) and control group (50 cases, nervous tension in the normal group) according to preoperative lumbar MRI of cauda equina syndrome and settlement of intraoperative detecting nerve tension. The Pfirrmann grade was used to evaluate degree of lumbar (L3/4-L5/S1) disc degeneration.The correlation between spinal nerve tension and lumbar disc degeneration was analyzed, and the severity of experimental group and control group on lumbar disc degeneration was compared. Results: There was no significant difference in the age and sex ratio between the two groups (P>0.05). The Pfirrmann score of the experimental group was L3/4 (4.74±1.6) grade, L4/5 (5.32±1.33) grade, L5/S1 (5.54±1.13) grade; the control group Pfirrmann score was L3/4 (3.5±1.16) grade, L4/5 (4.12±0.9) grade, and L5/S1 (4.1±0.97) grade.The severity of intervertebral disc degeneration in experimental group was higher than that in control group, with statistical significance (P<0.05). There was a correlation between lumbar disc degeneration and nerve tension in L3/4, L4/5 and L5/S1, and the correlation trend was L5/S1> L4/5> L3/4. Conclusion: There is a correlation between lumbar disc degeneration and spinal nerve high tension.A new pathogenesis of hanging intervertebral disc degeneration that the degeneration of lumbar disc is a compensatory mechanism in order to alleviate the axial stretch injury is put forward.

Concepts: Cauda equina syndrome, Normal subgroup, Statistics, Vertebral column, 2016, Spinal disc herniation, Cauda equina, Statistical significance

0

The purpose of this case report is to present a rare finding of an intradural extramedullary hemangioblastoma of the cauda equina, with literature review. Spinal hemangioblastomas account for 1-5% of all spinal cord tumors. While spinal hemangioblastomas are rare, it is exceedingly rare to have a case of intradural extramedullary hemangioblastoma of the spine, especially in isolation without von-Hippel-Lindau syndrome. Only 20 previous cases have been reported.

Concepts: Filum terminale, Cauda equina syndrome, Vertebral column, Spinal cord, Report, Case, The Spine, Cauda equina

0

Back pain, most frequently of the inflammatory type, is the leading symptom in patients with axial spondyloarthritis (axSpA). Back pain in these patients is usually either due to axial inflammation or structural changes based on new bone formation. However, there are other possible causes of pain in these patients. There is, for example, a strongly increased risk of vertebral fractures, and, especially in patients with longstanding disease, degenerative spinal changes may play an additional role as a cause of pain. Rarely, but rather specifically, patients with ankylosing spondylitis may develop subarachnoidal cysts that often cause neurologic symptoms, in extreme cases a cauda equina syndrome. It is therefore mandatory to always carefully evaluate the origin of back pain in these patients and to consider all possible differential diagnoses. The correct diagnosis is of major importance because treatments may differ considerably. In the monitoring of patients with axSpA it is especially important to consider that pain may have a different origin and it is crucial to notice changes in the nature of the reported back pain. Accordingly, the recently updated Assessment of Spondyloarthritis international Society (ASAS)/European League Against Rheumatism (EULAR) and the treat-to-target recommendations both define improvement of symptoms, a reduction of pain and abrogation of inflammation as important targets in axSpA that can be achieved by pharmacological and nonpharmacological treatments, in rare cases including surgical methods.

Concepts: Greek loanwords, Neurology, Symptoms, Spinal cord, Cauda equina syndrome, Medical terms, Cauda equina, Ankylosing spondylitis

0

Correlation between magnetic resonance imaging (MRI) and clinical features in cauda equina syndrome (CES) is unknown; nor is known whether there are differences in MRI spinal canal size between lumbar herniated disc patients with CES versus lumbar herniated discs patients without CES, operated for sciatica. The aims of this study are 1) evaluating the association of MRI features with clinical presentation and outcome of CES and 2) comparing lumbar spinal canal diameters of lumbar herniated disc patients with CES versus lumbar herniated disc patients without CES, operated because of sciatica.

Concepts: Cauda equina syndrome, Spinal disc herniation, Nuclear magnetic resonance, Cauda equina, Magnetic resonance imaging

0

Approximately 40% of patients with chronic low back pain have a neuropathic component. In this study, we assessed the effects of analgesics on tactile hypersensitivity and walking distance in the rat cauda equina compression (CEC) model of neuropathic low back pain.

Concepts: Back pain, Cauda equina syndrome, Cauda equina, Pain, Low back pain

0

To assess the impact of delayed decompression on long-term neurological and bladder function recovery in patients with cauda equina syndrome (CES) secondary to lumbar disc herniation (LDH).

Concepts: Paresthesia, Lumbar, Sciatica, Cauda equina syndrome, Hernia, Neurology, Cauda equina, Spinal disc herniation