794 results match your criteria Cauda Equina and Conus Medullaris Syndromes


Acute Spinal Cord Injury Due to Epidural Lipomatosis Without Osseous Injury.

Cureus 2022 May 22;14(5):e25212. Epub 2022 May 22.

Neurosurgery, Inova Neuroscience Institute, Falls Church, USA.

Spinal epidural lipomatosis (SEL) is a common pathology of the lumbar spine. While the natural history is not well understood, there is a strong association with metabolic syndrome and endocrine dysfunction. Clinical presentation typically involves slow, progressive onset of radicular and myelopathic symptoms. Read More

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Intradural intramedullary dermoid cyst in a 42-year-old man at the L1-L2 region.

N Am Spine Soc J 2022 Jun 17;10:100124. Epub 2022 May 17.

Ascension Health St Vincent Hospital, Department of Neurosurgery, Jacksonville FL, USA.

Background: Intramedullary dermoid cysts within the spine are a rare benign tumor. We present this case, which has atypical presenting symptoms, in order to increase awareness of intradural dermoid cysts.

Clinical Presentation: We present here a case of a 42 year old man with a 12-month history of lumbar spinal pain as well progressive left lower extremity loss of strength, as well as numbness and paresthesia radiating into the left foot. Read More

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Surgery in Acute Metastatic Spinal Cord Compression: Timing and Functional Outcome.

Cancers (Basel) 2022 Apr 30;14(9). Epub 2022 Apr 30.

Department of Neurosurgery, School of Medicine, Technical University of Munich, 81675 Munich, Germany.

Patients with metastatic spinal cord compression (MSCC) may experience long-term functional impairment. It has been established that surgical decompression improves neurological outcomes, but the effect of early surgery remains uncertain. Our objective was to evaluate the impact of early versus late surgery for acute MSCC due to spinal metastases (SM). Read More

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Management of cauda equina syndrome during pregnancy and postpartum.

BMJ Case Rep 2022 Apr 29;15(4). Epub 2022 Apr 29.

Department of Obstetrics and Gynecology, University of Florida, Gainesville, Florida, USA

Cauda equina syndrome (CES) is a rare condition that occurs from multiple nerve root compression. It is considered a surgical emergency because it can lead to permanent neurological damage. There is limited literature regarding management and prognosis of CES for pregnant patients, leaving providers with many questions when encountering patients with this condition. Read More

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Cranial and vertebral osteosarcoma commonly has T2 signal heterogeneity, contrast enhancement, and osteolysis on MRI: A case series of 35 dogs.

Vet Radiol Ultrasound 2022 Apr 22. Epub 2022 Apr 22.

Department of Large Animal Clinical Sciences, College of Veterinary Medicine and Biomedical Sciences, Texas A&M University, College Station, Texas, USA.

Magnetic resonance imaging (MRI) is commonly used to evaluate the central nervous system (CNS) in dogs; however, published studies describing the MRI appearance of cranial and vertebral osteosarcoma are scarce. In this multicenter, retrospective, case series study, MRI studies of 35 dogs with cranial or vertebral osteosarcoma were prospectively scored by consensus of two veterinary radiologists. Recorded characteristics were location, signal intensity (compared to gray matter), homogeneity, contrast enhancement, margin delineation, local invasion, osteolysis, osteosclerosis, zone of transition, periosteal proliferation, pathological fracture, meningeal/CNS involvement, and presence of metastatic disease. Read More

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Review/Perspective On the Diagnosis and Surgical Management of Spinal Arachnoid Cysts.

Authors:
Nancy E Epstein

Surg Neurol Int 2022 25;13:98. Epub 2022 Mar 25.

Clinical Professor of Neurosurgery, School of Medicine, State University of NY at Stony Brook, and c/o Dr. Marc Agulnick, 1122 Franklin Avenue Suite 106, Garden City, NY, 11530, USA.

Background: Spinal arachnoid cysts (SAC) are typically congenital, spontaneous, traumatic (i.e., including iatrogenic/surgical), or inflammatory in origin. Read More

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Compliance With the Cauda Equina Pathway: Results of a Closed-Loop Audit.

Cureus 2021 Dec 31;13(12):e20843. Epub 2021 Dec 31.

Trauma and Orthopaedics, Warrington and Halton Teaching Hospital NHS Foundation, Warrington, GBR.

Introduction The British Association of Spine Surgeons (BASS) and Society of British Neurological Surgeons (SBNS) recommend urgent MRI imaging and operative intervention in patients with suspected cauda equina syndrome (CES). Due to the lack of a 24-hour MRI service and the centralisation of neurosurgery to large tertiary centres, there is a need for an evidence-based protocol for the referral of patients presenting with back pain, with red flags to specialist tertiary neurosurgical centres. Methods The standard operating procedure (SOP) at our local hospital outlines steps in the assessment, triage and onward referral of patients presenting with symptoms of acute CES. Read More

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December 2021

Intramedullary spinal cord metastasis to the cauda equina in a patient with HER2-positive metastatic breast cancer: A case report.

Breast Dis 2022 ;41(1):155-161

Department of Pathology, Saitama Medical Center, Saitama, Japan.

The rate of metastasis to the central nervous system is high in human epidermal growth factor receptor 2 (HER2)-positive metastatic breast cancer patients. Metastatic cauda equina tumors are characterized by rapid progression of symptoms, thus signifying the requirement of their early treatment. However, these tumors are rarely reported, and their optimal treatment options have not been established yet. Read More

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Spinous Process Splitting Laminectomy for Lumbar Spinal Stenosis: 2D Operative Video.

World Neurosurg 2022 Mar 29;159:107. Epub 2021 Dec 29.

The Paley Orthopedic and Spine Institute at Saint Mary's Medical Center, West Palm Beach, Florida, USA.

Degenerative lumbar spinal stenosis involves an acquired reduction in the spinal canal diameter due to osteoarthritic changes on the disk, facet joints, and ligaments and may result in spinal cord or cauda equina compression. This process may lead to pain radiating to the legs, neurogenic claudication, and neurologic deficit. First-line treatment includes conservative care such as physical therapy, spinal injections, and lifestyle changes. Read More

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[Two cases of lumbar spinal stenosis with lumbar spondylolisthesis in elderly patients who benefited from spinal cord stimulation and an electrophysiological diagnosis].

Authors:
Nobukiyo Sumi

Nihon Ronen Igakkai Zasshi 2021 ;58(4):617-623

Sumi Orthopedic Rehabilitation Clinic.

Two elderly lumbar spinal stenosis (LSS) patients with spondylolisthesis underused with minimally invasive spinal cord stimulation (SCS) and electrophysiologic study of central motor conduction time (CMCT) and the cauda equina conduction time (CECT) were performed as spinal cord function evaluation. The usefulness of SCS treatment and electrophysiologic studies has been reported.A 68-year-old woman had bilateral leg pain, intermittent claudication, and left extensor hallucis longus (EHL) muscle weakness. Read More

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December 2021

Shortened total spine MRI protocol in the detection of spinal cord compression and pathology for emergent settings: a noninferiority study.

Emerg Radiol 2022 Apr 2;29(2):329-337. Epub 2021 Dec 2.

Division of Neuroradiology, Department of Radiology, Beth Israel Deaconess Medical Center, 330 Brookline Avenue, Boston, MA, 02115, USA.

Background And Purpose: Spinal cord compression (SCC) requires rapid diagnosis in the emergent setting; however, current MRI protocols may be cumbersome for patients and clinicians. We sought to validate an abbreviated total spine MRI (TS-MRI) protocol using standard non-contrast sequences in the detection of SCC and other clinically significant findings (OCSF).

Methods: Two hundred six TS-MRI scans obtained over a 30-month period for SCC were included. Read More

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Posterior epidural sequestrated disc presenting with contralateral radiculopathy: a very rare case.

Spinal Cord Ser Cases 2021 11 6;7(1):98. Epub 2021 Nov 6.

Spine Institute, Bumrungrad International Hospital, Bangkok, Thailand.

Introduction: Posterior epidural sequestrated disc is a fairly uncommon condition. We report a case of an unusual presentation of posterior epidural migration with contralateral symptoms. We emphasize a high index of suspicion for early recognition and treatment to promote a good neurological recovery. Read More

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November 2021

Clinical heterogeneity of low flow spinal arteriovenous fistulas; a case series.

BMC Neurol 2021 Sep 21;21(1):366. Epub 2021 Sep 21.

Department of Neurology, Hospital Kuala Lumpur, Jalan Pahang, 50586, Kuala Lumpur, Malaysia.

Background: Spinal AVF (SAVF), a potentially treatable cause of myelopathy, remains a challenging diagnosis. Its rarity and non-specific imaging findings often result in misdiagnosis despite a high index of clinical suspicion. The classically described high T2 signal in the spinal cord or prominent vascular flow voids in the intradural space were not infrequently missed on initial imaging, only to be picked up at follow-up imaging after progression of symptoms. Read More

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September 2021

Hodgkin Lymphoma Presenting With Spinal Cord Compression: Challenges for Diagnosis and Initial Management.

Pediatr Dev Pathol 2022 Mar-Apr;25(2):168-173. Epub 2021 Aug 24.

Department of Paediatric Haematology and Oncology, 2153Cambridge University Hospitals NHS Foundation Trust, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Hodgkin lymphoma (HL) can present with extra-nodal disease, but spinal cord compression is exceptionally rare. We describe a 15-year-old presenting with hip/back pain with normal initial examination. Persistent pain and raised inflammatory markers prompted further investigation with MRI, which revealed an epidural mass causing spinal cord compression. Read More

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Advances in radiotherapy in bone metastases in the context of new target therapies and ablative alternatives: A critical review.

Radiother Oncol 2021 10 29;163:55-67. Epub 2021 Jul 29.

Latin America Cooperative Oncology Group (LACOG), Porto Alegre, Brazil; Radiation Oncology Unit, Santa Maria Federal University, Santa Maria, Brazil; Clínica de Radioterapia de Santa Maria, Brazil. Electronic address:

In patients with bone metastases (BM), radiotherapy (RT) is used to alleviate symptoms, reduce the risk of fracture, and improve quality of life (QoL). However, with the emergence of concepts like oligometastases, minimal invasive surgery, ablative therapies such as stereotactic ablative RT (SABR), radiosurgery (SRS), thermal ablation, and new systemic anticancer therapies, there have been a paradigm shift in the multidisciplinary approach to BM with the aim of preserving mobility and function survival. Despite guidelines on using single-dose RT in uncomplicated BM, its use remains relatively low. Read More

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October 2021

[Epiconus Syndrome and Conus Syndrome].

Brain Nerve 2021 Jun;73(6):659-670

Department of Neurology, Chubu Rosai Hospital.

The most caudal part of the spinal cord shows special anatomical characteristics and it contains epiconus (L4-S2 segments), the conus medullaris (S3-S5 segments), and surrounding nerve roots. Lesions of the thoracolumbar junction cause epiconus or conus syndrome. Epiconus syndrome is characterized by segmental muscular weakness and atrophy of one or both lower extremities, often accompanied by foot drop. Read More

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Stereotactic body radiotherapy versus conventional external beam radiotherapy in patients with painful spinal metastases: an open-label, multicentre, randomised, controlled, phase 2/3 trial.

Lancet Oncol 2021 07 11;22(7):1023-1033. Epub 2021 Jun 11.

Canadian Clinical Trials Group, Queens's University, Kingston, ON, Canada.

Background: Conventional external beam radiotherapy is the standard palliative treatment for spinal metastases; however, complete response rates for pain are as low as 10-20%. Stereotactic body radiotherapy delivers high-dose, ablative radiotherapy. We aimed to compare complete response rates for pain after stereotactic body radiotherapy or conventional external beam radiotherapy in patients with painful spinal metastasis. Read More

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Lumbar disc sequestration through the dura into the intrathecal space presenting as acute cauda equina.

BMJ Case Rep 2021 May 5;14(5). Epub 2021 May 5.

Neurosurgery, University Hospitals Coventry and Warwickshire NHS Trust, Coventry, UK.

A 64-year-old man was referred to A&E by his general practitioner with worsening back and acute bilateral leg pain and weakness with urinary retention. His MRI scan demonstrated spinal canal stenosis at the level of L1-L2 and a diagnosis of cauda equina syndrome (CES) was made. CES is a rare neurological condition caused by compression of the central spinal nerves at the termination of the cord. Read More

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Transverse myelitis masquerading as cauda equina syndrome, stroke and cervical myelopathy.

Biomedicine (Taipei) 2020 28;10(1):45-50. Epub 2020 Mar 28.

Division of Spine, Department of Orthopaedic Surgery, Tan Tock Seng Hospital, Singapore.

Transverse myelitis is an uncommon but well-defined neurological syndrome. However, a high index of suspicion is needed to diagnose this condition, especially when it occurs in concomitance with preexisting spinal canal stenosis. We report our patient, a 48 year old male, who initially presented to our spine clinic with acute onset unilateral lower limb weakness associated with urinary retention, which was suspected to be cauda equina syndrome due to a prolapsed intervertebral disc. Read More

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Cauda Equina Syndrome as the Initial Presentation of Concurrent Plasmacytoma and Multiple Myeloma.

Cureus 2021 Jan 24;13(1):e12888. Epub 2021 Jan 24.

Internal Medicine, Brandon Regional Hospital, Tampa, USA.

Multiple myeloma is a hematological malignancy characterized by an abnormal proliferation of monoclonal plasma cells. In some occurrences, plasma cell proliferation results in a solitary lesion (solitary bone plasmacytoma or extramedullary plasmacytoma with minimal bone marrow involvement). Approximately 50% of patients with solitary plasmacytoma develop multiple myeloma within 10 years after the initial diagnosis. Read More

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January 2021

Anesthesia for Acute Spinal Cord Injury.

Anesthesiol Clin 2021 Mar;39(1):127-138

Department of Anesthesiology, Yale School of Medicine, Yale University, PO Box 208051, 333 Cedar Street, TMP 3, New Haven, CT 06510, USA.

The spinal cord extends from the base of the skull to the first lumbar vertebrae from which it continues as cauda equina. Injuries to the spinal cord can lead to significant short- and long-term morbidities. Depending on the level of injury, morbidities may include acute hemodynamic changes, weakness of respiratory muscles and ventilator dependence, and loss of bowel and bladder function. Read More

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Cauda equina compression in metastatic prostate cancer.

BMJ Case Rep 2020 Dec 17;13(12). Epub 2020 Dec 17.

Department of Trauma & Orthopaedic Surgery, Royal Shrewsbury Hospital, The Shrewsbury & Telford Hospital NHS Trust, Shrewsbury, UK

A 67-year-old man presented to his general practitioner with intermittent episodes of unilateral sciatica over a 2-month period for which he was referred for an outpatient MRI of his spine. This evidenced a significant lumbar vertebral mass that showed tight canal stenosis and compression of the cauda equina. The patient was sent to the emergency department for management by orthopaedic surgeons. Read More

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December 2020

Acute Spinal Extradural Hematoma and Cord Compression: Case Report and a Literature Review.

Cureus 2020 Nov 21;12(11):e11603. Epub 2020 Nov 21.

Emergency Department, Hamad Medical Corporation, Doha, QAT.

A 50-year-old Asian male presented to the emergency department with sudden onset of bilateral lower limb weakness preceded by lower back pain, which developed after lifting a moderately heavyweight. As the pain increased in intensity, the patient was transferred by ambulance to the emergency department, and en-route lost complete motor (0/5 power and absent reflexes) and sensory control over his lower limbs. The patient's medical history was significant for diabetes mellitus, hypertension, chronic kidney disease, and coronary artery disease with percutaneous coronary intervention in 2018 and 2019. Read More

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November 2020

Oblique Lateral Retroperitoneal Lumbar Pre-Psoas Approach for Vertebrectomy in Cancer Patients: Surgical Technique.

Surg Technol Int 2020 Nov;37:406-413

Department of Neurosurgery, IRCCS Istituto Nazionale Tumori "Regina Elena", Rome, Italy, Department of Neurosurgery, San Giovanni-Addolorata Hospital, Rome, Italy.

Due to the longer survival of cancer patients secondary to improved systemic treatments, there has been a recent increase in the incidence of spinal metastases. Metastatic disease involves the anterior vertebral body in 80% of cases. Progressive osseous invasion may result in pathologic vertebral fractures and neural structure compression. Read More

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November 2020

Metastatic epidural spinal column compression due to pancreatic ductal adenocarcinoma causing subacute Cauda equina syndrome: A case report.

Surg Neurol Int 2020 5;11:279. Epub 2020 Sep 5.

Department of Neurological Surgery, University of California, San Diego, La Jolla.

Background: Pancreatic ductal adenocarcinoma (PDAC) is the most common pancreatic malignancy, which rarely metastasizes to the spine.

Case Description: Here, we present a lytic lumbar metastatic PDAC resulting in severe epidural spinal cord compression (ESCC) with instability. The lesion required preoperative particle embolization, surgical decompression, and fusion. Read More

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September 2020

Cauda Equina Syndrome in Neurosarcoidosis.

Cureus 2020 Aug 27;12(8):e10069. Epub 2020 Aug 27.

Neurology, University of Connecticut School of Medicine, Hartford Hospital, Hartford, USA.

Neurosarcoidosis (NS) is a mimicker of many infectious, neoplastic, and inflammatory diseases. It most commonly involves the cranial nerves followed by meninges, ventricles, hypothalamic-pituitary axis, spinal cord, and brainstem/cerebellum. While NS myelopathy has been increasingly recognized, pathophysiological/prognostic and management principles in NS-mediated cauda equina (CE) and conus medullaris (CM) syndromes, which constitute a small and rare minority of this subset, remain elusive. Read More

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Delayed symptomatic spinal adhesive arachnoiditis after surgery for thoracolumbar flexion-distraction injury: A case report.

Int J Surg Case Rep 2020 29;74:273-276. Epub 2020 Aug 29.

Department of Orthopaedic Surgery, Seoul Spine Institute, Sanggyepaik Hospital, College of Medicine, Inje University, Republic of Korea.

Background: Adhesive arachnoiditis is an uncommon lesion caused by an inflammatory reaction in spinal nerves. Reports of substantial symptomatic thoracolumbar (TL) adhesive arachnoiditis after spinal surgery are rare. To the best of our knowledge, this is the first presentation of delayed adhesive arachnoiditis with cauda equina syndrome after decompression and fusion for a traumatic TL flexion-distraction injury. Read More

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Adapting Policy Guidelines for Spine Surgeries During COVID-19 Pandemic in View of Evolving Evidences: An Early Experience From a Tertiary Care Teaching Hospital.

Cureus 2020 Jul 11;12(7):e9147. Epub 2020 Jul 11.

Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND.

Introduction The recent novel coronavirus disease 2019 (COVID-19) pandemic has brought the world to a standstill. This outbreak not only affected healthcare systems but the resultant economic losses were also enormous. COVID-19 has demanded that the health care systems globally evolve, develop new strategies, identify new models of functioning, and at times, fall back on the old conservative methods of orthopedic care to decrease the risk of disease transmission. Read More

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Dorsal migration of lumbar disc fragments causing cauda equina syndromes: A three case series and literature review.

Surg Neurol Int 2020 4;11:175. Epub 2020 Jul 4.

Department of Neurosurgery, SUNY Upstate Medical University Hospital, Syracuse, New York, United States.

Background: Dorsal migration of an intervertebral lumbar disc fragment is exceedingly rare and may result in spinal cord or cauda equina compression. Radiologically, these lesions may be misdiagnosed as extradural masses or epidural hematomas.

Case Description: We present three cases involving dorsal migration of sequestered lumbar disc fragments resulting in cauda equina syndromes. Read More

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