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PubMed1993

Intradural conus and cauda equina tumours: a retrospective review of presentation, diagnosis and early outcome.

This is a retrospective review of the clinical presentation, diagnosis and management of 62 patients with histologically proven intradural conus and cauda equina tumours. In the majority of cases the clinical presentation clearly suggests the need for further investigation. One fifth of the patients had small intramedullary tumours, which presented particular diagnostic difficulty and required sophisticated cross sectional imaging.

Adolescent↗
PubMed1981

Myeloscopy, with special reference to blood flow changes in the cauda equina during Lasègue's test.

Myeloscopy has been undertaken in a series of 208 patients without any serious complications. Observations have been made of changes in blood flow in the vessels accompanying the cauda equina during Lasègue's test and in some pathological states. Direct observation of the nucleus pulposus has been achieved and the possibility of the removal of herniated disc material by use of the myeloscope is suggested.

Back Pain↗
PubMed1996

Case report: magnetic resonance imaging of primary lymphoma of the cauda equina.

Malignant lymphoma of the central nervous system is usually confined within the cranium, with primary involvement of the spinal cord and nerve roots being very rare. The occurrence of primary lymphoma in the cauda equina in a 16-year-old Chinese male is reported. Contrast enhancement during magnetic resonance imaging is useful in accurately demonstrating disease extent prior to surgery.

Adolescent↗
PubMed1983

[Association of ankylosing spondylarthritis, cauda equina syndrome and dilatation of the lumbar cul-de-sac with voluminous arachnoid diverticulum. Clinical, radiological and tomodensitometric study of a case].

The authors report a clinical and radiological observation of cauda equina syndrome associated with ankylosing spondylitis. Although only 32 cases have been reported in the literature over the last twenty years, such an association is probably not exceptional. The mode of onset and the course of the neurological symptoms is quite similar from case to case: ankylosing spondylitis preexisting for many years, and inactive when neurological signs develop, the latter usually being very slowly progressive. The usual radiological features, demonstrated by saccoradiculography in the supine position, are posterior diverticulas of the lumbar theca, contiguous to bony erosions of the laminae, well visualized by computed tomography. Pathogenesis remains obscure, and none of the attempted therapies, including surgical procedures, have proved effective.

Aged↗
PubMed1998

Granulocytic sarcoma presenting as cauda equina syndrome.

Granulocytic sarcoma (GS) is a tumour formed by myeloid precursors in an extramedullary site and is associated with myeloid leukaemias and other myeloproliferative disorders. We present a patient with symptoms of cauda equina compression where MRI of the spine showed extradural lesions at S1 and L3 levels. This patient had normal bone marrow and peripheral blood for a further 6 weeks from onset of symptoms. Such aleukaemic presentations of GS are rare and have potential for misdiagnosis and delay in treatment. Therefore we recommended early open biopsy of such tumours.

Adult↗
PubMed1993

Cauda equina syndrome secondary to lumbar disc herniation.

Between 1986 and 1991, 14 patients (nine men and five women), ranging in age from 22 to 67 years (mean, 43 yr), presented with acute cauda equina syndrome from a herniated lumbar disc. All presented with bilateral sciatica and leg weakness; 13 (93%) had urine or stool incontinence, or both. At presentation, all were emergently studied with myelogram/computed tomographic or magnetic resonance imaging. Nine (64%) had large or massive herniations, including two with tethered cords. Five had smaller herniations superimposed on preexisting stenosis. Three had previous surgery; two-thirds had a herniation at a different level. The levels of the herniations were L4-L5 in nine patients, L5-S1 in three patients, and L3-L4 in two patients. The time to surgery ranged from less than 24 hours to more than 30 days; 11 patients underwent surgery within 5 days of onset. Follow-up ranged from 6 months to 5 years (mean, 3.3 yr). Postoperatively, six patients (44%) were normal, four (28%) had chronic pain and numbness, and four (28%) had persistent incontinence and weakness. All the patients were ambulatory. There were no operative deaths, and only one patient had a wound infection. Of the 10 patients who had no incontinence after surgery, 7 underwent surgery within 48 hours of onset. Of the four patients with persistent incontinence, all underwent surgery after 48 hours. Previous reports and our experience demonstrate the following most common characteristics for this presentation: 1) male sex; 2) L4-L5 herniations; and 3) onset in the 4th decade.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1999

Cauda equina syndrome complicating pneumococcal meningitis.

A 14-month-old female with pneumococcal meningitis presented with flaccid paraplegia, saddle anesthesia, and bladder and bowel dysfunction. Magnetic resonance imaging of the spine demonstrated intense gadolinium enhancement of the cauda equina, whereas the conus medullaris appeared normal. This finding indicated that lumbosacral polyradiculopathy caused her symptoms.

Cauda Equina↗
PubMedDate not supplied

[Late results of the surgical treatment of spondylolisthesis complicated by injury of the cauda equina].

In 1971-1985 surgical treatment was carried out of 29 patients in the Neurosurgery Department WAM in Lódź and 5 in the Rehabilitation Centre in Konstancin for spondylolisthesis complicated with signs of cauda equina damage. In the surgical treatment the technique used was that of a combination of neurosurgical approach (full decompression of the nervous elements in the vertebral canal by laminectomy with foraminectomy or facetectomy, removal of protruding discs and osteophytes and parts of the vertebral bodies narrowing the vertebral canal), and orthopaedic procedures (spondylodesis between vertebral bodies posterior spondylodesis and a combination of both techniques). In one case spring alloplasty was done and in one case Harrington's rods were used. The operation was carried out at one time from the same posterior approach. The follow-up was from 1 to 15 years. A very good result was obtained in 20.6% of cases, good in 55.9%, satisfactory in 23.5%. In no case of worsening or lack of improvement were observed.

Adult↗
PubMed1994

[Back lumbar herniated discs and cauda equina syndrome as complications of Scheuermann's disease. A case report].

The author reports the case of a patient with spinal cord compression by a thoracic herniated disc without paraplegia as well as a cauda equina syndrome due to spondylotic and discal lesions, with small protrusions of the L4-L5 and L5-S1 discs associated with Scheuermann disease. There was complete recovery in six months with clinical treatment. The radiological evaluation using standard radiography, myelography, computed tomography, magnetic resonance imaging of the vertebral column, and electromyographic evaluation indicate a precise correlation between clinical picture and the distribution and course of lumbar spinal cord degenerations. Furthermore, a strong correlation was also found with hernias, roots and the bony sequalae of spinal cord dystrophy found in Scheuermann disease.

Cauda Equina↗
PubMed1980

Epidural angiolipoma producing compression of the cauda equina.

Epidural angiolipomas are rare tumours and are histologically benign, but their myelographic and macroscopic appearance is malignant. Surgical results are satisfactory. A case is reported in a 48-year-old woman with a slowly progressive cauda equina compression syndrome in whom an epidural angiolipoma was successfully removed. The special feature of this case was a generalized severe spinal osteoporosis with a pathological fracture of a vertebral body at the level of the tumour.

Cauda Equina↗
PubMed1984

Somatosensory cerebral potentials evoked by stimulation of the lumbo-sacral spinal cord in normal subjects and in patients with conus medullaris and cauda equina lesions.

Somatosensory cerebral evoked potentials were recorded by intrathecal stimulation of the lumbo-sacral cord and roots in 16 normal subjects and patients having cauda/conus injury (group A, 15 cases), compressive lesions of cauda equina (group B, 13 cases) and lesions of both types covering the lumbar cord (group C, 24 cases). The shape of the intrathecally evoked cerebral potential (IECP) was basically the same as that obtained by posterior tibial nerve stimulation from 12 normal subjects except that the early components were 10-15 msec shorter in latency in the former potential, with an average of 12 msec. IECPs were easily recorded in groups A and B, but a significant delay was found in both groups, especially group A. It was difficult to obtain the IECP in group C, When it could be recorded the latency increase was apparent. These findings were explained on the basis of degeneration of the ascending spinal nerve fibers proximal to the lesion site.

Adult↗
PubMed2003

Palliation and survival in metastatic tumors compressing the cauda equina: a 19-year radiotherapeutic experience.

UNLABELLED: PURPOSE; Radiotherapy (RT) offers a means of promoting an acceptable quality of life in people with incurable cancer. We reviewed our radiotherapeutic experience of metastatic tumors compressing the cauda equina (MTCCE) because large case series and achieved palliation in these patients are infrequently documented in the literature. METHODS: Seventy-six individuals undergoing RT for MTCCE were identified from a 19-year period (1981-1999). Treatment responses and survival were assessed. RESULTS: Pain relief was complete in 94%, partial in 3%, and not achieved in 3% of the 32 evaluated patients. Complete resolution of impaired sensation in the lower limbs occurred in three cases, and of anal or bladder sphincter dysfunction in three persons also. Among the 28 evaluable individuals with lower extremity motion impairment, 11 (39%) were nonambulatory and 17 (61%) were ambulatory following treatment. The overall median survival was 3 months; the survival rate at 1 year was 18% and at 3 years 8%. CONCLUSION: Although long-term survival is not to be expected, the usefulness of RT for palliation of MTCCE may be trusted.

Adult↗
PubMed1995

Cauda equina syndrome, diskospondylitis, and a paravertebral abscess caused by Rhodococcus equi in a foal.

A 4-month-old male Quarter Horse was referred for evaluation of urinary incontinence. Physical examination revealed clinical signs consistent with cauda equina syndrome. Radiography revealed diskospondylitis of S2 through S4. Infected bone was surgically curretted, and drainage was established for an associated paravertebral abscess. Rhodococcus equi was isolated from specimens of bone and from fluid samples obtained from the paravertebral abscess. Bethanechol was administered to stimulate urination. Erythromycin and rifampin were administered for 120 days. The foal's neurologic dysfunction resolved completely. Two years after discharge, the horse remained neurologically normal and did not have apparent effects as a result of its previous disorder.

Abscess↗