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Responsiveness to P2 of blood- and cauda equina-derived lymphocytes in experimental allergic neuritis in the Lewis rat: preliminary characterisation of a P2-specific cauda equina-derived T cell line.

Experimental allergic neuritis (EAN) was induced in Lewis rats by immunisation with bovine spinal root myelin. Neurological signs appeared on day 12 and persisted for 10-15 days. A transient protein P2-specific proliferative response of circulating mononuclear cells was detected on days 10 and 14 after immunisation but not on days 17 and 35. Mononuclear cells recovered from cauda equina infiltrates on days 14 and 17 showed greater responsiveness to P2 than circulating cells. A P2-specific, interleukin-2-dependent T cell line has been developed from cauda equina (CE)-derived lymphocytes. In adoptive transfer experiments this cell line did not induce EAN but did protect normal recipients from actively induced EAN.

Animals↗

Cauda equina-penetrating injury in a child. Case report.

The authors report the case of a 10-year-old boy who sustained an injury to the cauda equina as a result of the accidental penetration of a wooden pencil into the spinal canal. After neuroimaging evaluation to exclude visceral and vascular lesions, the foreign body was removed and the wound was repaired. This is the first report of a cauda equina injury caused by a pencil.

Cauda Equina↗

Intact arch spondylolisthesis. A review of 50 cases and description of surgical treatment.

Over the past 11 years, the authors have treated 50 cases of intact arch spondylolisthesis. There were 38 female and 12 male patients, and all but 11 were older than 60 years of age. Almost all had severe low-back pain made worse by standing or walking. Other common manifestations were unilateral leg pain, numbness or weakness of the leg, and evidence of mild cauda equina compression. Severe cauda equina compression was rare. Myelography invariably showed an extradural dorsal compression. A waist deformity was characteristic in many patients, but 12 had a complete block. In 15 patients (30%) the myelographic impression was that of a herniated intervertebral disc. Most subluxations were of L-4 on L-5. At operation, the facets were found to be thickened, distorted, and irregular. All patients were treated with a wide decompression and laminectomy, which included a medial facetectomy of the inferior and superior facets. An intervertebral disc was removed in 10 patients. Follow-up monitoring of 41 patients (for an average period of 36 months) showed that 26 (63%) were pain-free, 11 had less pain, and four were unimproved. Five other patients with short follow-up periods (average 5 months) were all improved.

Aged↗

Assessment of lumbar spinal canal stenosis by magnetic resonance phlebography.

There is evidence to suggest that cauda equina intermittent claudication is caused by local circulatory disturbances in the cauda equina as well as compression of the cauda equina. We evaluated the role of magnetic resonance phlebography (MRP) in identifying circulatory disturbances of the vertebral venous system in patients with lumbar spinal canal stenosis. Extensive filling defects of the anterior internal vertebral venous plexus were evident in patients with lumbar spinal canal stenosis ( n = 53), whereas only milder abnormalities were noted in patients with other lumbar diseases ( n = 16) and none in normal subjects ( n = 13). The extent of the defect on MRP correlated with the time at which intermittent claudication appeared. In patients with lumbar spinal canal stenosis, extensive defects of the internal vertebral venous plexus on MRP were noted in the neutral spine position, but the defect diminished with anterior flexion of the spine. This phenomenon correlated closely with the time at which intermittent claudication appeared. Our results highlight the importance of MRP for assessing the underlying mechanism of cauda equina intermittent claudication in patients with lumbar spinal canal stenosis and suggest that congestive venous ischemia is involved in the development of intermittent claudication in these patients.

Adult↗