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Results for “CAUDA EQUINA”

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At least 19 recordsLinked to original sources
PubMed1998

Postlaminectomy adhesion of the cauda equina. Inhibitory effects of anti-inflammatory drugs on cauda equina adhesion in rats.

STUDY DESIGN: Effects of the systemic administration of anti-inflammatory drugs on cauda equina adhesion after lumbar laminectomy were evaluated in rats. OBJECTIVES: To obtain basic data on preventive measures for lumbar adhesive arachnoiditis. SUMMARY OF BACKGROUND DATA: Laminectomy-induced cauda equina adhesion has been proved by rat experiments and postoperative serial magnetic resonance imaging tests in humans. In rats, laminectomy induces an increase in vascular permeability, resulting in cauda equina adhesion. METHODS: Wistar rats laminectomized from L5 to L6 were divided into three groups: the control group received only vehicle solutions, the indomethacin group received oral indomethacin for 7 days, and the steroid group was administered intraperitoneal methylprednisolone for 3 days. At 24 hours and 3 weeks and 6 weeks after laminectomy, cauda equina adhesion and leakage of a protein tracer from the nutrient vessels were histologically compared in the three groups. RESULTS: Both indomethacin and methylprednisolone significantly suppressed cauda equina adhesion and protein leakage from the nutrient vessels at 24 hours after laminectomy. Rats treated with the anti-inflammatory drugs showed diminution of cauda equina adhesion and the neural degeneration at 3 weeks and 6 weeks after laminectomy. CONCLUSIONS: Anti-inflammatory drug administration before and after laminectomy suppressed cauda equina adhesion as well as facilitating recovery from cauda equina adhesion.

Animals↗
PubMed1998

Chronic double-level cauda equina compression. An experimental study on the dog cauda equina with analyses of nerve conduction velocity.

STUDY DESIGN: Nerve conduction velocity was studied in the dog cauda equina subjected to chronic double-level compression. OBJECTIVES: To analyze the effects of chronic double-level cauda equina compression. SUMMARY OF BACKGROUND DATA: Double-level cauda equina compression produces more symptoms in patients and more changes in acute experimental set-ups than does single-level compression. However, there have been no controlled, experimental studies on chronic double-level compression. METHODS: A total of 20 dogs were anesthetized. Two balloons were placed under the lamina of the seventh lumbar vertebra and the first sacral vertebra, respectively. One week (10 mm Hg, n = 5; 0 mm Hg, n = 5) and 1 month (10 mm Hg, n = 5; 0 mm Hg, n = 5) after inflation with a viscous substance, nerve conduction velocity was studied by local electrical stimulation and recording of muscle action potentials in the tail muscles. RESULTS: Nerve conduction velocity was determined over the cranial balloon, the caudal balloon, and both balloons. The data were similar for all three recordings. After 1 week there was a significant reduction in nerve conduction velocity induced by 10 mm Hg, compared with that induced by 0 mm Hg, which showed normal conditions. However, after 1 month this initial reduction in nerve conduction velocity had recovered partially. The reduction was similar to that described for single-level compression in a previous study in which the same compression model was used. CONCLUSIONS: Unlike the acute situation, chronic double-level compression does not induce more changes than single-level compression after 1 week, although the recovery after 1 month of compression is less complete after double-level compression. This less complete recovery may be a result of an adaptation of the nerve tissue and the vascularization of the cauda equina nerve roots to the applied pressure.

Action Potentials↗
PubMed1995

Intermittent cauda equina compression. An experimental study of the porcine cauda equina with analyses of nerve impulse conduction properties.

STUDY DESIGN: Neurophysiologic reactions of cauda equina nerve roots to intermittently applied compression were assessed for two different modes of compression using a porcine model. OBJECTIVE: To assess the neurophysiologic reactions of cauda equina nerve roots to intermittently applied compression. SUMMARY OF BACKGROUND DATA: A number of experimental studies have been presented recently regarding the reaction pattern of spinal nerve roots to compression. These studies have used a continuous pressure level. For studies of pathophysiologic mechanisms behind neurogenic claudication, however, it would be more relevant to study the effects of intermittently applied compression. METHODS: The cauda equina was exposed and compression was applied by two inflatable balloons. Two different modes of compression were used. Either the two balloons were inflated and deflated simultaneously (intermittent compression), or just the caudal balloon was inflated and deflated while the cranial balloon was kept continuously inflated (continuous/intermittent compression). The experimental series were: intermittent compression at 10 mm Hg (n = 5) and 50 mm Hg (n = 5), and continuous/intermittent compression at 10 mm Hg (n = 5) and 50 mm Hg (n = 5). For both modes of compression the pressure in the balloons with intermittent inflation was maintained for 10 minutes and deflated for 5 minutes. This procedure was repeated in 8 cycles for 2 hours. Muscle action potentials were recorded in the tail muscles. RESULTS: Compression at 10 mm Hg induced similar reductions of muscle action potentials for both compression modes. At 50 mm Hg, the effects were more pronounced at continuous/intermittent compression than at intermittent compression. The reduction of muscle action potentials was slightly more pronounced for 50 than for 10 mm Hg at intermittent compression. However, a statistically significant difference in the results was found only between 10 and 50 mm Hg at the continuous/intermittent compression mode. CONCLUSIONS: The established model allows investigation of the effects of intermittent cauda equina compression, which might be clinically more relevant than continuous compression regarding the pathophysiologic mechanisms behind neurogenic claudication.

Action Potentials↗
PubMed1996

[The time factor in cauda equina syndrome].

Cauda equina syndrome is a rare but potentially catastrophic complication of lumbar disc disease. In spite of properly performed surgical decompression, the outcome is mostly unsatisfactory. One of the important factors influencing the recovery of motor function of the lower extremities, sensation, bladder and rectum control, sexual function, as well as working ability is thought to be the duration of cauda equina compression. The evaluation of data obtained in a group of 58 persons (21 women and 37 men) operated upon for discogenic cauda equina syndrome in the period of time from January 1, 1982 to December 31, 1991 did not confirm this opinion. (Tab. 7, Ref. 23.).

Adult↗
PubMed1995

A model for acute, chronic, and delayed graded compression of the dog cauda equina. Presentation of the gross, microscopic, and vascular anatomy of the dog cauda equina and accuracy in pressure transmission of the compression model.

STUDY DESIGN: A new model for controlled, graded compression of the dog cauda equina was developed using the dog lumbar spine. The model was defined regarding macroscopic, microscopic, and vascular anatomy and regarding accuracy in pressure transmission. OBJECTIVES: The study was performed to develop a model for controlled, graded compression that would allow for acute, chronic, and delayed compression. SUMMARY OF BACKGROUND DATA: There has been an increasing interest for the reactions of the spinal nerve roots to mechanical deformation. The previously used models have had limitations regarding the duration and the onset of the compression and possibilities for a controlled variation of the compression pressure on chronically compressed nerve roots. METHODS: Macroscopic examination, light microscopy, and ink injection of the vasculature was used to assess the anatomic characteristics of the nerve tissue and the vasculature of the cauda equina in the dog lower lumbar spine. The relation between known pressures in the compression balloon used to compress the cauda equina and the pressure in the central thecal sac was assessed by measuring the pressure in an artificial thecal sac with a pressure transducer. RESULTS. The neural and vascular anatomy was found to have a close resemblance to the human cauda equina. The pressure in the thecal sac was within 5% of the pressure in the compression balloon at various pressures between 0-200 mm Hg. CONCLUSION: The presented model provides a good pressure transmission to the dog cauda equina, which has an anatomy that closely resembles the human cauda equina. The model may be well suited for physiologic studies of cauda equina compression. A double-balloon system may provide unique opportunities to induce chronic compression and delayed compression, i.e., additional compression after a certain time of chronic compression to resemble the changes in pressure that are characteristic for neurogenic claudication.

Animals↗
PubMed1982

Clinical recording of pressure on the spinal cord and cauda equina. Part 2: position changes in pressure on the cauda equina in central lumbar spinal stenosis.

To define the site, degree, and dynamics of mechanical compression of the spinal nerve roots, pressure was measured in 42 patients with clinical symptoms and myelographic findings indicating central lumbar spinal stenosis. Pathological pressure on the cauda equina was found in 67% of the patients. The pressure in the region of the spinal block was high during standing and walking, and in several patients exceeded mean arterial blood pressure. The block pressure was the main mechanical factor in the central part of the spinal canal causing pain and paresis. Elevated fluid pressure caudal to the block was an additional but usually subordinate factor. In 33% of the patients, normal pressure on the cauda equina was found, and lateral compression of multiple nerve roots seemed to be the only mechanical symptom-causing factor. Clinically, these patients could not be distinguished from patients with central compression. After laminectomy with decompression of the cauda equina, the field should be inspected for lateral narrowing which, if present, should be treated.

Adult↗
PubMed2003

Unexpected complication of attempted epidural anaesthesia: cauda equina syndrome.

Cauda equina syndrome after regional anaesthesia is a serious and devastating complication. Its occurrence after epidural anaesthesia is rare. We report a 46-year-old male who received epidural anaesthesia for ureterorenoscopic lithotripsy and developed cauda equina syndrome postoperatively. Despite one failed attempt at entering the epidural space with an epidural needle resulting in dural puncture, an epidural catheter was inserted and 20 ml pH adjusted lignocaine 2% with 1:200,000 adrenaline injected via the catheter without untoward event. The possible causes of this complication are discussed. Fortunately, this patient recovered almost completely ten months later.

Anesthesia, Epidural↗
PubMed1995

Laser Doppler study of porcine cauda equina blood flow. The effect of electrical stimulation of the rootlets during single and double site, low pressure compression of the cauda equina.

STUDY DESIGN: This study involved a model of spinal claudication to assess the effect of single and double site compressions on blood flow in porcine cauda equina. Real-time monitoring of blood flow was achieved by using laser Doppler probes. OBJECTIVES: To ascertain the difference between single and double site compressions on blood flow and nerve conduction in the cauda equina. Also, to provide possible explanations for the mechanisms underlying the pathophysiology of neurogenic claudication. SUMMARY OF BACKGROUND DATA: The model used was based on that of K. Olmarker. Double as compared with single site compression of cauda equina showed impaired nerve impulse propagation and decreased blood flow. METHOD: Pigs weighing 22-27 kg were anesthesized and the cauda equina was exposed by dorsal laminectomy of the sacral and first three coccygeal vertebrae. Polyethylene balloons were placed over the rootlets at the first and third coccygeal segments, and stimulating electrodes were positioned on the rootlets proximally to evoke motor activity. Electromyographic activity was monitored from tail musculature. Laser Doppler probes monitored blood flow in the cauda equina both between and distal to the two compression sites. RESULTS: Single site, low level compression did not affect blood flow whereas double site compression decreased it profoundly. Proximal stimulation caused a marked increase in blood flow, which was not sustained during prolonged compression. Electromyographic activity diminished concomitantly during this compression. CONCLUSIONS: Low pressure, double site compression significantly reduces cauda equina blood flow and prevents the sustained increase in blood flow required to maintain normal neurologic rootlet function. Local blood flow failure may therefore be responsible for claudication symptoms.

Animals↗
PubMed1999

Spinal subarachnoid hemorrhage attributable to schwannoma of the cauda equina.

BACKGROUND: Cauda equina syndrome occurring as a result of spontaneous spinal subarachnoid hemorrhage (SAH) from a spinal tumor is reported to be rare. CASE DESCRIPTION: A 28-year-old woman presented at our clinic with a history of severe back pain for 10 days, progressive paraparesis, and urinary retention. Her physical examination revealed a mass located intradurally at the level of L1-2 and a massive SAH. An L1-L2, laminectomy and a hemilaminectomy from D9 to D12 were performed and the SAH was evacuated and the cord was decompressed. CONCLUSION: At the first year follow-up, her restricted dorsal and plantar flexion continued. Post-gadolinium magnetic resonance imaging revealed no mass.

Adult↗
PubMed1994

Patients age and results of treatment in discogenic cauda equina syndrome.

Cauda equina syndrome is a feared complication of lumbar disc disease. Despite of early surgery it frequently leaves persistent effects. Localisation, type, and duration of spinal nerve roots compression are quoted as the most important factors influencing the results of treatment. Statistical evaluation of data acquired by examinations of 58 persons operated on for this disease et the Department of Neurosurgery in Kosice within the period from January 1st, 1982 to December 31st, 1991 has shown that the further important facts are ageing of tissues and impairment of microcirculation. In patients over the age of 45 the recovery of motor and sexual functions, as well as the voluntary control of rectal sphincters, and the working ability were significantly worse. It is suggested thereby that in elderly persons with a proven intervertebral disc disease an early surgical intervention is indicated. (Tab. 7, Ref. 23.)

Adult↗
PubMed1993

Double-level cauda equina compression: an experimental study with continuous monitoring of intraneural blood flow in the porcine cauda equina.

Compression of the spinal nerve roots may occur clinically at multiple levels at the same time; however, the basic pathophysiology of multi-level compression is largely unknown. In this study, the intraneural blood flow was analyzed continuously in the uncompressed segment between two compression balloons, with a pig used as an experimental model and a thermal diffusion method. At 10 mm Hg compression, there was a 64% reduction of total blood flow in the uncompressed segment compared with pre-compression values. Total ischemia occurred at pressures 10-20 mm Hg below the mean arterial blood pressure. After two-level compression at 200 mm Hg for 10 min, there was a gradual recovery of the intraneural blood flow towards the baseline. Recovery was less rapid and less complete after 2 h of compression. Double-level compression of the cauda equina can thus induce impairment of blood flow, not only at the compression sites, but also in the intermediate nerve segments located between two compression sites, even at very low pressures. These findings may have clinical importance in the understanding of the pathophysiology of multiple-level cauda equina compression.

Animals↗
PubMed1999

Cauda equina syndrome after spinal anaesthesia with hyperbaric 5% lignocaine: a review of six cases of cauda equina syndrome reported to the Swedish Pharmaceutical Insurance 1993-1997.

Six cases of cauda equina syndrome with varying severity were reported to the Swedish Pharmaceutical Insurance during the period 1993-1997. All were associated with spinal anaesthesia using hyperbaric 5% lignocaine. Five cases had single-shot spinal anaesthesia and one had a repeat spinal anaesthetic due to inadequate block. The dose of hyperbaric 5% lignocaine administered ranged from 60 to 120 mg. Three of the cases were most likely caused by direct neurotoxicity of hyperbaric 5% lignocaine. In the other 3 cases, direct neurotoxicity was also probable, but unfortunately radiological investigations were not done to definitely exclude a compressive aetiology. All cases sustained permanent neurological deficits. We recommend that hyperbaric lignocaine should be administered in concentrations not greater than 2% and at a total dose preferably not exceeding 60 mg.

Adult↗