RE: Cauda equina syndrome as a postoperative complication in five patients operated for lumbar disc herniation. Spine 2001; 26: 293-7.
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Serpentine filling defects caused by redundant nerve roots were demonstrated myelographically in three patients with a nonionic, water-soluble contrast material. All patients had either total obstruction or severe stenosis of the subarachnoid space secondary to extradural lesions.
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A 7-year-old castrated male Rottweiler was evaluated for an 18-month history of bilateral hind limb lameness, signs of pain on rising, and mild ataxia. A gas-filled lumbosacral disk space (vacuum disk phenomenon) was revealed by use of computed tomography. Additional smaller gas bubbles were in the periphery of the disk and between the degenerated L5-L6 dorsal articular facets (vacuum facet phenomenon). Vacuum disk and facet phenomena have been described in humans with degenerative disk and vertebral articular facet joint disease; gas attracted from surrounding tissues accumulates within clefts of the degenerated disk or in unstable facet joints. Vacuum disk phenomenon has been reported in dogs and indicates degenerative disk disease. The phenomenon is more commonly observed by use of computed tomography, compared with conventional radiography, and can be elicited by hyperextension of the vertebral column.
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Relatively little attention has been paid to lumbar spine involvement in rheumatoid arthritis (RA), and indeed it is generally considered to be an uncommon and usually clinically minor manifestation of the disease. We describe a case of acute right lower extremity weakness secondary to compression of multiple lumbar nerve roots by a large interforaminal rheumatoid pannus, and review the literature on this complication and other lumbar spine involvement in RA.
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