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At least 703 records · Page 39Linked to original sources
PubMed2005

A case report of rapidly progressing cauda equina symptoms due to rheumatoid arthritis.

Although rheumatoid involvement of the lumbar spine is relatively rare, we report a patient with rapidly progressing cauda equina symptoms due to rheumatoid diskitis. A 72-year-old woman was admitted to our hospital because of motor weakness below the iliopsoas muscle and sensory disturbance beneath the level of L2. Plain X-ray films, computed tomography, and magnetic resonance imaging demonstrated destruction of the L2/3 intervertebral disc and endplates with subluxation of the facet joints. The dural sac was compressed. Based on a diagnosis of spinal canal stenosis due to rheumatoid diskitis, we performed partial laminectomy and posterolateral fusion with pedicle screws. The neurological deficits improved immediately. The mechanism of intervertebral disc destruction in this case is thought to be rheumatoid nodes or enthesitis. Destruction of the facet joints and the intervertebral disc might have led to severe instability and spinal canal stenosis.

Aged↗
PubMed2004

[Conus medullaris and cauda equina infarct in the course of thrombosis of deep veins of lower extremities].

A 61-year man showed symptoms of conus medullaris and cauda equina syndrome. MR examination of spine and spinal cord SL section showed changes in medullary cone of ischaemial character. Spinal cord injury was probably caused by thrombosis of spinal cord venous vessels, which developed, with diabetes of the second type, in the result of appendectomy complicated by peritonitis and thrombosis of deep veins of the right shank.

Diabetes Mellitus, Type 2↗
PubMed2007

Delays in the treatment of cauda equina syndrome due to its variable clinical features in patients presenting to the emergency department.

OBJECTIVE: To identify reasons for delay in management of patients with cauda equina syndrome (CES) and to determine commonly presented features of CES. METHODS: Retrospectively, the presenting features and management of patients treated for CES over a 4-year period were reviewed. RESULTS: Reasons for delay in treatment were identified in over half of the patients. DISCUSSION: Most patients do not present with all the characteristic features of CES. Sacral sensory loss is a sensitive and relatively specific sign for diagnosing CES.

Adult↗
PubMed2001

Fos protein expression in sacral spinal cord in relation to early phase of cauda equina syndrome in dogs.

1. The aim of the present study is to map the incipient phase of Fos expression in the sacral spinal cord neuronal pools of multiple cauda equina constrictions canine model. 2. Fos-positive neurons were found bilaterally in the lateral portion of superficial dorsal horn layers (Laminae I-III) and along the lateral edge of the dorsal horn accompanied by the lateral collateral pathway, fibers of Lissauer's tract, terminating at the sacral parasympathetic nucleus. Similarly, high Fos expression was detected in the ventral portion of the dorsal sacral commissure and in the dorsomedial portion of the anterior horns at S1-S3 segment level. Finally, a clearly expressed Fos-positivity was disclosed bilaterally in the neuropil of the nucleus Y in the anterior horn. 3. Data from the present study show that continuous stimulation of the central fibers of sacral dorsal root ganglia neurons, i.e., fibers of sacral primary afferents, unlike those using various stimulations of the peripheral fibres offers an unusual pattern of Fos-like immunoreactivity.

Animals↗
PubMed2007

Cauda equina syndrome: factors affecting long-term functional and sphincteric outcome.

STUDY DESIGN: Retrospective cohort study with prospective clinical follow-up. OBJECTIVE: To determine the factors that influence outcome after surgery for cauda equina syndrome (CES). SUMMARY OF BACKGROUND DATA: CES is a rare but serious consequence of lumbar disc prolapse and can have devastating long-lasting neurologic consequences. The timing of surgical decompression remains controversial. METHODS: Fifty-six patients with evidence of a sphincteric disturbance who underwent urgent surgery were identified and invited to follow-up. The outcome measures comprised history and examination and several validated self-assessment questionnaires. RESULTS: Forty-two patients (78%) attended with a mean follow-up of 60 months (range, 25-114 months). Mean age at onset was 41 years (range, 24-67 years) with 23 males and 19 females. Twenty-six patients were operated on within 48 hours of onset of sphincteric symptoms; 5 of these were within 24 hours. Acute onset of sphincteric symptoms and the time to operation did not influence the outcomes. Leg weakness at onset persisted in a significant number of patients at follow-up (P < 0.005). Urinary disturbance at presentation did not affect the outcomes. At follow-up, significantly more females had urinary incontinence (P < 0.005). Bowel dysfunction at presentation was associated with sexual problems at follow-up (P < 0.005). The 13 patients who failed their post operative trial without catheter had worse outcomes. The SF-36 scores at follow-up were reduced compared with age-matched controls in the population. The mean ODI was 29, Low Back Outcome Score 42, and VAS 4.5. The time elapsed from operation to follow-up was not found to influence the outcomes. CONCLUSIONS: In our series, the symptom duration before operation and the speed of onset do not affect the outcome more than 2 years after surgery. Based on the SF-36, ODI, and Low Back Outcome Scores, patients who have had CES do not return to a normal status.

Adult↗
PubMed2004

Infectious origins of cauda equina syndrome.

Infections in the spine can lead to a wide range of problems for both the patient and physician. There is perhaps no more devastating complication than the neurological consequences of a cauda equina syndrome due to spinal infection. A variety of organisms and origins can make diagnosis and treatment of spinal infection a difficult task. Both pyogenic and nonpyogenic organisms can cause vertebral involvement and can result in an epidural abscess with neurological compromise. Nonetheless, these two types of infections vary greatly in terms of associated patient demographics, clinical course, and treatments. The purpose of this paper was to review these types of infections and summarize treatment recommendations for this difficult condition.

Debridement↗