722 results match your criteria Cauda Equina and Conus Medullaris Syndromes


Vertebral solitary bone plasmacytoma in a young adult with Trisomy 21: A case report.

J Spinal Cord Med 2018 Dec 17:1-4. Epub 2018 Dec 17.

a Neurology's Department , Habib Bourguiba Hospital , Sfax , Tunisia.

Context: Solitary bone plasmacytoma (SBP) are rare lesions, accounting for less than 5% of all plasma cell proliferations. We describe a case of a 21-year-old female with Trisomy 21 presenting with cauda equina compression from an SBP.

Findings: Solitary bone plasmacytoma (SBP) is a rare primary bone tumor. Read More

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http://dx.doi.org/10.1080/10790268.2018.1557866DOI Listing
December 2018

Anti-coagulation Drug Warfarin Contributes to Severe Adverse Outcomes in Prolonged Unsupervised Use: A Double-edged Sword.

Cureus 2018 Sep 22;10(9):e3347. Epub 2018 Sep 22.

Neurological Surgery, Haider Spine Center, Riverside, USA.

Anti-coagulation medications are widely used in clinical practice, especially in the United States as cardiac-related emergencies are on the rise. An overarching caveat in using anti-coagulation drugs as a long-term treatment regimen, such as warfarin, is that patients are closely monitored by their primary care provider. Routine monthly laboratory examinations are strictly required to assess the international normalized ratio (INR) which measures prothrombin time (PT), providing insight into how long it takes for blood to clot. Read More

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https://www.cureus.com/articles/14892-anti-coagulation-drug-
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http://dx.doi.org/10.7759/cureus.3347DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6248782PMC
September 2018
4 Reads

Pyogenic Spondylodiscitis: Risk Factors for Adverse Clinical Outcome in Routine Clinical Practice.

Med Sci (Basel) 2018 Oct 30;6(4). Epub 2018 Oct 30.

Department of Infection and Tropical Medicine, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne NE1 4LP, UK.

We aimed to describe the clinical features and outcomes of pyogenic spondylodiscitis and to identify factors associated with an unfavourable clinical outcome (defined as death, permanent disability, spinal instability or persistent pain). In our tertiary centre, 91 cases were identified prospectively and a retrospective descriptive analysis of clinical records was performed prior to binary regression analysis of factors associated with an unfavourable outcome. A median 26 days elapsed from the onset of symptoms to diagnosis and 51% of patients had neurological impairment at presentation. Read More

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http://www.mdpi.com/2076-3271/6/4/96
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http://dx.doi.org/10.3390/medsci6040096DOI Listing
October 2018
5 Reads

Spontaneous Epidural Hematoma of Cervical Spine.

Int J Spine Surg 2018 Jan 30;12(1):26-29. Epub 2018 Mar 30.

Department of Neurosurgery, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran.

Spontaneous cervical epidural hematoma is an uncommon cause of acute spinal cord compression. This is a rare idiopathic condition that leads to acute onset of neurologic deficits, which if not recognized early can have catastrophic consequences. Acute cervical epidural hematoma is definitely a condition of neurologic emergency. Read More

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http://dx.doi.org/10.14444/5005DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6162037PMC
January 2018
1 Read

Fungal cauda equina lesion with delayed cord compression and treatment response.

Clin Neurol Neurosurg 2018 Nov 21;174:185-186. Epub 2018 Sep 21.

University of Vermont Medical Center, Department of Neurological Sciences, 111 Colchester Avenue, Burlington, VT, 05401, United States. Electronic address:

This is a 24 year old man with profound chronic hydrocephalus found to have a cauda equina abscess composed of Candida albicans. Prior literature reveals a paucity of central nervous system candidiasis. In these previously reported cases, there was evidence of local invasion of surrounding structures; however, this case is a sentinel report of a fungal abscess without evidence of local structural invasion. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S03038467183039
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http://dx.doi.org/10.1016/j.clineuro.2018.09.029DOI Listing
November 2018
12 Reads

Aspiration of sterile post-operative spinal fluid collections using low-dose computed tomography guidance.

J Clin Neurosci 2018 Nov 25;57:202-207. Epub 2018 Aug 25.

Department of Radiologic Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA. Electronic address:

Sterile postoperative seromas can develop after posterior spinal surgery and cause pain, weakness, and numbness. Management typically involves operative evacuation. We propose that these collections can be managed with percutaneous computed tomography (CT) guided aspiration, potentially saving the patient an additional surgery. Read More

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http://dx.doi.org/10.1016/j.jocn.2018.08.011DOI Listing
November 2018
2 Reads

Symptomatic spinal epidural lipomatosis after combined hormonal and steroidal palliative therapy of prostate cancer.

Spinal Cord Ser Cases 2018 10;4:75. Epub 2018 Aug 10.

3Radiology Department, Queen's Medical Centre, Nottingham University Hospitals NHS Trust, Derby Road, Nottingham, NG7 2UH UK.

Introduction: Spinal epidural lipomatosis (SLE) is an abnormal accumulation of unencapsulated fat. The association of chronic steroid therapy is described as well as obesity and Cushing's syndrome. SLE has a range of neurological presentations such as back pain, myelopathy, and cauda equina syndrome. Read More

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http://dx.doi.org/10.1038/s41394-018-0107-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6086905PMC
August 2018
9 Reads

Myelopathy from Intradural Extramedullary Metastasis as an Initial Presentation of Metastatic Melanoma.

Cureus 2018 May 22;10(5):e2668. Epub 2018 May 22.

Neurosurgery, Maimonides Medical Center.

The incidence of metastatic melanoma (MM) has been steadily rising, and it is the third most common metastatic lesion to the central nervous system (CNS). Spinal intradural extramedullary (IDEM) MM is rare, and it is associated with coexisting or antecedent brain metastasis. Metastatic disease to the CNS is a complication of advanced disease, and it generally occurs months to years after initial diagnosis and treatment. Read More

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http://dx.doi.org/10.7759/cureus.2668DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6054369PMC
May 2018
2 Reads

Rapid Fire: Central Nervous System Emergencies.

Emerg Med Clin North Am 2018 Aug 12;36(3):537-548. Epub 2018 Jun 12.

Department of Emergency Medicine, University of Maryland Medical Center, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA; Department of Internal Medicine, University of Maryland Medical Center, 110 South Paca Street, 6th Floor, Suite 200, Baltimore, MD 21201, USA.

Neurologic complications are unfortunately common in oncology patients, with many presenting to the emergency department for diagnosis and management. This case-based review provides a brief overview of the key points in pathophysiology, diagnosis, and management of 2 oncologic central nervous system emergencies: malignant spinal cord compression and intracranial mass. Read More

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http://dx.doi.org/10.1016/j.emc.2018.04.010DOI Listing
August 2018
2 Reads

Incomplete Cord Syndromes: Clinical and Imaging Review.

Radiographics 2018 Jul-Aug;38(4):1201-1222

From the Department of Radiology, SUNY Downstate Medical Center, University Hospital of Brooklyn, 450 Clarkson Ave, Brooklyn, NY 11203 (V.K.K., V.V., Z.A.C., D.L.R.); Department of Radiology, University of California Davis Health System, Sacramento, Calif (M.B.); and Department of Radiology, University of Iowa Hospital and Clinics, Iowa City, Iowa (W.R.K.S.).

The ability to localize the three spinal tracts (corticospinal tract, spinothalamic tract, and dorsal [posterior] columns) involved in incomplete spinal cord syndromes at cross-sectional imaging and knowledge of the classic clinical manifestations of the various syndromes enable optimized imaging evaluation and provide clinicians with information that aids in diagnosis and treatment. The requisite knowledge for localizing these tracts is outlined. The authors review the spinal cord anatomy, blood supply, and course of these tracts and describe the various associated syndromes: specifically, dorsal cord, ventral cord, central cord, Brown-Séquard, conus medullaris, and cauda equina syndromes. Read More

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http://dx.doi.org/10.1148/rg.2018170178DOI Listing
October 2018
3 Reads

Metastatic biphasic pleural mesothelioma presenting with cauda equina syndrome.

Radiol Case Rep 2018 Jun 18;13(3):736-739. Epub 2018 May 18.

Darent Valley Hospital, Kent, UK.

Patient with previous asbestos exposure on a watchful wait and watch regime presents acutely with cauda equina syndrome. Radiological imaging confirmed a mass with direct invasion of the spinal cord. Histology confirmed metastatic pleural mesothelioma. Read More

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http://dx.doi.org/10.1016/j.radcr.2018.03.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6026097PMC
June 2018
2 Reads

Kinetic and kinematic variables affecting trunk flexion during level walking in patients with lumbar spinal stenosis.

PLoS One 2018 10;13(5):e0197228. Epub 2018 May 10.

Department of Medical Research and Management for Musculoskeletal Pain, 22nd Century Medical and Research Center, The University of Tokyo, Tokyo, Japan.

Lumbar spinal stenosis causes cauda equina and nerve root compression, resulting in neurological symptoms. Although trunk flexion during level walking may alleviate these symptoms by enabling spinal canal decompression, some patients do not use this strategy. We aimed to identify the kinetic and kinematic variables that affect trunk flexion in patients during level walking. Read More

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http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0197228PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5944950PMC
July 2018
2 Reads

Long-Term Outcomes After Stereotactic Radiosurgery for Spine Metastases: Radiation Dose-Response for Late Toxicity.

Int J Radiat Oncol Biol Phys 2018 Jul 6;101(3):602-609. Epub 2018 Mar 6.

Department of Radiation Oncology, University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, Pennsylvania. Electronic address:

Purpose: To document the 5- and 10-year rates of late toxicity and vertebral compression fracture (VCF) in long-term survivors after stereotactic radiosurgery for spine metastases.

Methods And Materials: A retrospective review was performed on 562 patients treated with SRS for spine metastases between April 2001 and July 2011. Selecting those with at least 5-year survival after SRS, included were 43 patients who collectively underwent 84 treatments at 54 spine sites. Read More

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http://dx.doi.org/10.1016/j.ijrobp.2018.02.035DOI Listing
July 2018
1 Read

Disorders of the Cauda Equina.

Authors:
Brent P Goodman

Continuum (Minneap Minn) 2018 Apr;24(2, Spinal Cord Disorders):584-602

Purpose Of Review: Conditions that affect the cauda equina are a diverse group of disorders that require timely recognition and management. This article reviews cauda equina anatomy, the diagnostic approach to disorders of the cauda equina, features of cauda equina syndrome, and diskogenic and nondiskogenic disorders of the cauda equina.

Recent Findings: Establishing clinical criteria for cauda equina syndrome has been a focus of a number of reviews, although the clinician must maintain a low threshold for emergent imaging in cases of suspected cauda equina syndrome because of the suboptimal reliability of various signs and symptoms in identifying this condition clinically. Read More

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http://dx.doi.org/10.1212/CON.0000000000000584DOI Listing
April 2018
3 Reads

Caudal lumbar spinal cysts in two French Bulldogs.

Acta Vet Scand 2018 Mar 1;60(1):14. Epub 2018 Mar 1.

Department of Clinical Sciences of Companion Animals, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 108, 3584 CM, Utrecht, The Netherlands.

Background: Spinal cysts are rare findings in veterinary medicine, but they are increasingly recognized due to the availability of advanced imaging techniques. Extradural meningeal cysts in French Bulldogs have not been reported previously and arachnoid cysts (diverticula) have not been reported at the caudal lumbar (L6-L7) region in dogs.

Case Presentation: Two French Bulldogs, aged 5 and 8 years, were referred for evaluation of lower back pain and bilateral hind limb neurological deficits. Read More

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http://dx.doi.org/10.1186/s13028-018-0368-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5831591PMC
March 2018
12 Reads

The importance of the bulbocavernosus reflex.

Spinal Cord Ser Cases 2018 10;4. Epub 2018 Jan 10.

Spinal Unit, Centre Calve, Fondation Hopale, Berck-sur-Mer, France.

The BCR consists of the contraction of the bulbocavernosus muscle in response to squeezing the glans penis or clitoris, and is mediated through the pudendal nerve. In case of a complete lesion, the presence of BCR is indicative of intact S2-S4 spinal reflex arcs and loss of supraspinal inhibition, determining an upper motor neuron (UMN) lesion, its absence a lower motor neuron (LMN) lesion. The BCR further helps distinguish conus medullaris from cauda equina syndromes. Read More

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http://dx.doi.org/10.1038/s41394-017-0012-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5798690PMC
January 2018

Analysis of stress application at the thoracolumbar junction and influence of vertebral body collapse on the spinal cord and cauda equina.

Exp Ther Med 2018 Feb 27;15(2):1177-1184. Epub 2017 Nov 27.

Department of Orthopedic Surgery, Yamaguchi University Graduate School of Medicine, Ube, Yamaguchi 755-8505, Japan.

The thoracolumbar junction comprises the spinal cord, nerve roots and the cauda equina, exhibiting unique anatomical features that may give rise to a diverse array of symptoms under conditions of injury, thus complicating the diagnosis of compressive disorders. The present study aimed to examine varying degrees and forms of compression at this level of the spinal cord using a two-dimensional model to calculate the relationship of these variables to injury. The degree of compression was expressed as a percentage of the spinal canal that was occupied. Read More

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http://dx.doi.org/10.3892/etm.2017.5570DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5774549PMC
February 2018

Cauda Equina Syndrome Due to Lumbar Disc Herniation: a Review of Literature.

Folia Med (Plovdiv) 2017 Dec;59(4):377-386

3Department of Medical Imaging, Allergology and Physical Medicine, Faculty of Dental Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria.

Cauda equina syndrome (CES) is a rare neurologic condition that is caused by compression of the cauda equina. Cauda equina consists of spinal nerves L2-L5, S1-S5 and the coccygeal nerve. The compression of these nerve roots can be caused mainly by lumbar disc herniation (45% of all causes). Read More

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http://dx.doi.org/10.1515/folmed-2017-0038DOI Listing
December 2017
7 Reads

Rare Thymoma Metastases to the Spine: Case Reports and Review of the Literature.

World Neurosurg 2018 Feb 6;110:423-431. Epub 2017 Dec 6.

Department of Neurosurgery, Cleveland Clinic Foundation, Cleveland, Ohio, USA; Center for Spine Health, Neurological Institute, Cleveland Clinic Foundation, Cleveland, Ohio, USA. Electronic address:

Background: We report a series of 3 cases of metastatic thymoma to the spine with spinal cord compression. An extensive literature review of thymic metastases to the spine was completed to provide a comprehensive appraisal of current prognostic indicators and potential treatment algorithms to help guide clinicians in treatment management.

Case Descriptions: Between 2000 and 2017, 3 patients received diagnoses of thymic metastases to the spine at our institution. Read More

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http://dx.doi.org/10.1016/j.wneu.2017.11.161DOI Listing
February 2018
11 Reads

Survival analysis of malignant epidural spinal cord compression after palliative radiotherapy using Tokuhashi scoring system and the impact of systemic therapy.

Ann Palliat Med 2017 Dec 29;6(Suppl 2):S132-S139. Epub 2017 Aug 29.

Hong Kong Academy of Medicine (Radiology), Department of Clinical Oncology, Tuen Mun Hospital, Hong Kong SAR, China.

Background: Previous studies have shown similar clinical outcomes of both single and multi-fraction (Fr) radiation therapy among malignant epidural spinal cord compression (MSCC) patients with poor prognosis; whereas, patients expected to have longer survival may require long-course radiotherapy to prevent local failure. However, such a poor prognosis risk group has not yet been clearly identified for use in daily clinical practice. We examined if the known predictive Tokuhashi scoring system could be adapted in MSCC patients treated with palliative radiation therapy. Read More

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http://dx.doi.org/10.21037/apm.2017.07.06DOI Listing
December 2017
7 Reads

Conus Medullaris Arachnoid Cyst Presenting as Cauda Equina Syndrome.

Asian J Neurosurg 2017 Oct-Dec;12(4):707-709

Department of Neurosurgery, Liaquat National Hospital and Medical College, Karachi, Pakistan.

Intradural arachnoid cysts are a rare cause of spinal cord and nerve root compression. Primarily, they are present in the thoracic region posteriorly. We report a 25-year-old man who had an intradural arachnoid cyst at the level of conus medullaris presenting with cauda equina syndrome, which is very rare. Read More

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http://www.asianjns.org/text.asp?2017/12/4/707/215777
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http://dx.doi.org/10.4103/ajns.AJNS_36_15DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5652101PMC
November 2017
23 Reads

PEMLIF-a tale of two stories.

J Spine Surg 2017 Sep;3(3):498-503

Department of Neurosurgery, Government Medical College, Thiruvananthapuram, India.

Intervertebral disc prolapse is a common cause of both acute and chronic low back pain. This can result in differential grades of motor and sensory disturbances in lower limbs and even cauda equina syndrome (CES). The neurological manifestations are a result of compression of the spinal cord and roots ventrally in the spinal canal due to the prolapsed disc. Read More

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http://dx.doi.org/10.21037/jss.2017.08.07DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5637195PMC
September 2017
6 Reads

A Good Short-term Outcome in Delayed Decompression of Cauda Equina Syndrome in Spinal Epidural Abscess: A Case Report.

Malays Orthop J 2017 Jul;11(2):85-88

Department of Orthopaedics, Universiti Sains Malaysia, Kubang Kerian, Malaysia.

Spinal epidural abscess is a severe, generally pyogenic, infection of the epidural space of spinal cord or cauda equina. The swelling caused by the abscess leads to compression or vascular disruption of neurological structures that requires urgent surgical decompression to avoid significant permanent disability. We share a rare case of spinal epidural abscess secondary to haematogenous spread of previous lung infection that presented late at our centre with cauda equina syndrome that showed good short-term outcome in delayed decompression. Read More

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http://dx.doi.org/10.5704/MOJ.1707.018DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5630060PMC
July 2017
12 Reads

Effects of duloxetine on pain and walking distance in neuropathic pain models via modulation of the spinal monoamine system.

Eur J Pain 2018 02 26;22(2):355-369. Epub 2017 Sep 26.

Pain & Neuroscience, Drug Discovery & Disease Research Laboratory, Shionogi & Co., Ltd., Toyonaka, Osaka, Japan.

Background: Approximately 40% of patients with chronic low back pain have a neuropathic component. In this study, we assessed the effects of analgesics on tactile hypersensitivity and walking distance in the rat cauda equina compression (CEC) model of neuropathic low back pain.

Methods: The effects of analgesics on tactile hypersensitivity were examined using the von Frey test in CEC and partial sciatic nerve ligation (pSNL) models. Read More

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http://dx.doi.org/10.1002/ejp.1125DOI Listing
February 2018
6 Reads

Postoperative stereotactic body radiotherapy for spinal metastases.

Chin Clin Oncol 2017 Sep;6(Suppl 2):S18

Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, University of Toronto, Toronto, ON, Canada.

Spine is a common site of metastases in cancer patients. Spine surgery is indicated for select patients, typically those with mechanical instability and/or malignant epidural spinal cord (or cauda equina) compression. Although post-operative conventional palliative external beam radiation therapy has been the standard of care, technical improvements in radiation planning and image-guided radiotherapy have allowed for the application of stereotactic body radiotherapy (SBRT) to the spine. Read More

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http://dx.doi.org/10.21037/cco.2017.06.27DOI Listing
September 2017
10 Reads

Does Surgical Intervention or Timing of Surgery Have an Effect on Neurological Recovery in the Setting of a Thoracolumbar Burst Fracture?

J Orthop Trauma 2017 Sep;31 Suppl 4:S38-S43

*Krembil Research Institute, Toronto Western Hospital, University Health Network, Toronto, ON, Canada; †Department of Orthopaedics, Faculty of Medicine, University of British Columbia, Vancouver, BC, Canada; ‡Department of Orthopaedic Surgery, The Rothman Institute, Thomas Jefferson University, Philadelphia, PA, USA; §Division of Neurosurgery, Department of Surgery, University of Toronto, ON, Canada; ‖Institute of Medical Science, University of Toronto, Toronto, ON, Canada; ¶McEwen Centre for Regenerative Medicine, UHN, University of Toronto, Toronto, ON, Canada; **Spine Program, University of Toronto, Toronto, ON, Canada; ††McLaughlin Center in Molecular Medicine, University of Toronto, Toronto, ON, Canada; and ‡‡Genetics and Development, Krembil Discovery Tower, Toronto Western Hospital, Toronto, ON, Canada.

Traumatic thoracolumbar burst fractures are one of the most common forms of spinal trauma with the majority occurring at the junctional area where mechanical load is maximal (AOSpine Thoracolumbar Spine Injury Classification System Subtype A3 or A4). Burst fractures entail the involvement of the middle column, and therefore, they are typically associated with bone fragment in the spinal canal, which may cause compression of the spinal cord, conus medullaris, cauda equina, or a combination of these. Fortunately, approximately half of the patients with thoracolumbar burst fractures are neurologically intact due to the wide canal diameter. Read More

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http://dx.doi.org/10.1097/BOT.0000000000000946DOI Listing
September 2017
26 Reads

Incomplete cauda equina syndrome secondary to haemorrhage within a Tarlov cyst.

BMJ Case Rep 2017 Aug 7;2017. Epub 2017 Aug 7.

Exeter Spine Unit, Royal Devon and Exeter Hospital, Exeter, Devon, UK.

Sacral perineural (Tarlov) cysts are benign, cerebrospinal fluid containing lesions of the spinal nerve root sheath. They are usually asymptomatic; however, a small proportion have the potential to cause compression of nerve roots and/or the cauda equina.We report a case of a 61-year-old man who presented with acute onset back pain associated with bilateral radiculopathy. Read More

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http://dx.doi.org/10.1136/bcr-2017-219890DOI Listing
August 2017
27 Reads

Incidental Primary Intradural Carcinoid Tumor in a Patient with Lumbar Radiculopathy.

World Neurosurg 2017 Sep 11;105:1042.e11-1042.e14. Epub 2017 Jul 11.

Department of Neurosurgery, Beaumont Hospital, Dublin, Ireland.

Background: Carcinoid tumors are neuroendocrine neoplasms derived from enterochromaffin cells. Central nervous system involvement is rare. The reported cases include metastases to brain or spinal cord, and primary skeletal or extradural disease resulting in compressive myeloradiculopathy. Read More

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http://dx.doi.org/10.1016/j.wneu.2017.06.179DOI Listing
September 2017
10 Reads

Definitions of traumatic conus medullaris and cauda equina syndrome: a systematic literature review.

Spinal Cord 2017 Oct 23;55(10):886-890. Epub 2017 May 23.

Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands.

Study Design: A systematic review.

Objectives: Conus medullaris syndrome (CMS) and cauda equina syndrome (CES) are well-known neurological entities. It is assumed that these syndromes are different regarding neurological and functional prognosis. Read More

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http://dx.doi.org/10.1038/sc.2017.54DOI Listing
October 2017
9 Reads

Less Is More: Efficacy of Rapid 3D-T2 SPACE in ED Patients with Acute Atypical Low Back Pain.

Acad Radiol 2017 08 3;24(8):988-994. Epub 2017 Apr 3.

Department of Radiology, University of Utah Health Sciences Center, 30 North 1900 East #1A071, Salt Lake City, UT 84132-2140.

Rationale And Objectives: Emergency department (ED) patients with acute low back pain (LBP) may present with ambiguous clinical findings that pose diagnostic challenges to exclude cauda equina syndrome (CES). As a proof of concept, we aimed to determine the efficacy of a rapid lumbar spine (LS) magnetic resonance imaging (MRI) screening protocol consisting of a single 3D-T2 SPACE FS (3D-T2 Sampling Perfection with Application optimized Contrasts using different flip angle Evolution fat saturated) sequence relative to conventional LS MRI to exclude emergently treatable pathologies in this complex patient population.

Materials And Methods: LS MRI protocol including a sagittal 3D-T2 SPACE FS pulse sequence was added to the routine for ED patients presenting with acute atypical LBP over a 12-month period. Read More

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https://linkinghub.elsevier.com/retrieve/pii/S10766332173012
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http://dx.doi.org/10.1016/j.acra.2017.02.011DOI Listing
August 2017
13 Reads

Ejaculation and sperm characteristics in men with cauda equina and conus medullaris syndromes.

Spinal Cord 2017 Jun 14;55(6):612-617. Epub 2017 Feb 14.

Laboratoire de neuro-urologie et de sexologie, Centre Bouffard-Vercelli, Cerbère, France.

Study Design: Retrospective.

Objectives: The objective of the study was to describe the type of ejaculation in patients with cauda equina (CE) and conus medullaris (CM) lesions, and to analyse sperm quality.

Setting: France. Read More

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http://dx.doi.org/10.1038/sc.2017.5DOI Listing
June 2017
6 Reads

Development of a simple, rapid, and robust intrathecal catheterization method in the rat.

J Neurosci Methods 2017 03 2;280:36-46. Epub 2017 Feb 2.

Ionis Pharmaceuticals, Inc., 2855 Gazelle Court, Carlsbad, CA 92010, USA.

Background: The blood brain barrier (BBB) is an impediment to the development of large and highly charged molecules as therapeutics for diseases and injuries of the central nervous system (CNS). Antisense oligonucleotides (ASOs) are large (6000-8000MW) and highly charged and therefore do not cross the BBB. A method of circumventing the blood brain barrier to test ASOs, and other non-BBB penetrant molecules, as CNS therapeutics is the direct administration of these molecules to the CNS tissue or cerebral spinal fluid. Read More

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http://dx.doi.org/10.1016/j.jneumeth.2017.02.001DOI Listing
March 2017
12 Reads

Spinal cord compression and non-traumatic cauda equina syndrome

Rev Prat 2017 02;67(2):e93-e100

Hôpital Henry-Gabrielle, Hospices civils de Lyon, 69230. Université Lyon-I-Claude-Bernard, 69100 Villeurbanne, France.

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February 2017
6 Reads

Diagnosis and treatment of epidural metastases.

Cancer 2017 04 27;123(7):1106-1114. Epub 2016 Dec 27.

Department of Neurology, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, Massachusetts.

Epidural metastases occur in 5% to 10% of cancer patients and represent a neurological emergency. Patients most commonly present with an acute onset of motor weakness, and restoration of neurological function is critically dependent on prompt diagnosis and treatment. This review discusses the clinical, epidemiological, and radiological features associated with epidural metastases and resulting spinal cord compression. Read More

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http://dx.doi.org/10.1002/cncr.30521DOI Listing
April 2017
7 Reads

Prevalence of thoracic spine lesions masquerading as cauda equina syndrome: yield of a novel magnetic resonance imaging protocol.

Intern Emerg Med 2017 Dec 4;12(8):1259-1264. Epub 2016 Nov 4.

Department of Emergency Medicine, San Antonio Uniformed Services Health Education Consortium, SAMMC, MCHE-EMR, 3551 Roger Brooke Dr, JBSA, Fort Sam Houston, TX, 78234-6200, USA.

Our objective was to describe the yield of actionable thoracic spine lesions for a novel magnetic resonance imaging (MRI) protocol including evaluation of the thoracic spine among patients presenting to the Emergency Department (ED) with symptoms consistent with epidural compression syndrome. Our ED and Department of Radiology together designed a novel rapid MRI protocol entailing 3D volumetric T2 weighted sequences through both the thoracic and lumbar spine obtained in the sagittal plane to assess for both lumbar and thoracic spine lesions. We recorded study outcomes for all patients undergoing this protocol or conventional lumbar MRI during May 2014-May 2015 to determine the prevalence of actionable thoracic spine lesions. Read More

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http://dx.doi.org/10.1007/s11739-016-1565-9DOI Listing
December 2017
8 Reads

The Factors That Affect Improvement of Neurogenic Bladder by Severe Lumbar Disc Herniation in Operation.

Korean J Spine 2016 Sep 30;13(3):124-128. Epub 2016 Sep 30.

Department of Neurosurgery, Naeun Hospital, Incheon, Korea.

Objective: This study analyzed retrospectively the bladder function of patients after early surgery for cauda equina syndrome (CES) performed within 24 or 48 hours, or after 48 hours of the onset of autonomic symptoms.

Methods: We retrospectively reviewed the clinical data of 31 patients after decompression surgery for lumbar disc herniation (LDH) who had been diagnosed with CES between January 2001 and December 2014 at Inha University Hospital. The following factors were assessed to evaluate the influence of time to surgery: bladder function, rectal incontinence, sexual dysfunction, LDH level, and degree of spinal canal compression. Read More

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http://dx.doi.org/10.14245/kjs.2016.13.3.124DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5086463PMC
September 2016
8 Reads

Re-irradiation stereotactic body radiotherapy for spinal metastases: a multi-institutional outcome analysis.

J Neurosurg Spine 2016 Nov 24;25(5):646-653. Epub 2016 Jun 24.

Department of Radiation Oncology, Sunnybrook Odette Cancer Centre, and.

OBJECTIVE This study is a multi-institutional pooled analysis specific to imaging-based local control of spinal metastases in patients previously treated with conventional external beam radiation therapy (cEBRT) and then treated with re-irradiation stereotactic body radiotherapy (SBRT) to the spine as salvage therapy, the largest such study to date. METHODS The authors reviewed cases involving 215 patients with 247 spinal target volumes treated at 7 institutions. Overall survival was calculated on a patient basis, while local control was calculated based on the spinal target volume treated, both using the Kaplan-Meier method. Read More

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http://dx.doi.org/10.3171/2016.4.SPINE151523DOI Listing
November 2016
26 Reads

Impact of spinal cord compression from intradural and epidural spinal tumors on perioperative symptoms-implications for surgical decision making.

Neurosurg Rev 2017 Jul 7;40(3):377-387. Epub 2016 Oct 7.

Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.

Spinal cord or cauda equina compression (SCC) is an increasing challenge in clinical oncology due to a higher prevalence of long-term cancer survivors. Our aim was to determine the clinical relevance of SCC regarding patient outcome depending on different tumor entities and their anatomical localization (extradural/intradural/intramedullary). We retrospectively analyzed 230 patients surgically treated for SCC. Read More

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http://dx.doi.org/10.1007/s10143-016-0790-zDOI Listing
July 2017
13 Reads

[Surgical treatment of lumbar disc herniation].

Oper Orthop Traumatol 2017 Feb 29;29(1):59-85. Epub 2016 Sep 29.

Schön Klinik München Harlaching, Wirbelsäulenzentrum, Akademisches Lehrkrankenhaus und Institut für Wirbelsäulenforschung der Paracelsus Medizinischen Privatuniversität Salzburg (PMU), Österreich, Harlachinger Str. 51, 81547, München, Deutschland.

Objective: Herniated disc tissue removal to decompress the spinal nerve/cauda equina. Minimization of iatrogenic trauma and associated injuries.

Indications: Conservative treatment did not sufficiently improve clinical symptoms. Read More

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http://dx.doi.org/10.1007/s00064-016-0467-3DOI Listing
February 2017
11 Reads

A clinically relevant MRI grading system for lumbar central canal stenosis.

Clin Imaging 2016 Nov - Dec;40(6):1140-1145. Epub 2016 Jul 21.

Department of Head of Femur, Linyi Peoples' Hospital, Linyi, 276003, China. Electronic address:

Objective: To correlate lumbar spinal stenosis as graded on noncontrast magnetic resonance imaging (MRI) with clinical symptomatology.

Methods: Five grades were developed for lumbar central canal stenosis based on compression of the dural sac and cauda equina. We studied concordance in 112 patients between the grading system and the anteroposterior diameter of spinal canal, dural sac cross-sectional area, Oswestry disability index, and the pain visual analogue scale (VAS). Read More

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http://dx.doi.org/10.1016/j.clinimag.2016.07.005DOI Listing
January 2017
10 Reads

Histopathological examination of spine tumors after treatment with radiosurgery.

Neurosurg Focus 2016 Aug;41(2):E14

Departments of 1 Neurological Surgery and.

OBJECTIVE Increased survival time after diagnosis of neoplastic disease has resulted in a gradual increase in spine tumor incidence. Radiosurgery is frequently a viable alternative to operative management in a population with severe medical comorbidities. The authors sought to assess the histopathological consequences of radiosurgery in the subset of patients progressing to operative intervention. Read More

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http://dx.doi.org/10.3171/2016.5.FOCUS16119DOI Listing
August 2016
38 Reads

Idiopathic Lumbar Epidural Lipomatosis Mimicking Disc Herniation: A Case Report.

Acta Med Iran 2016 May;54(5):337-8

Department of Radiology, School of Medicine, Mevlana University, Konya, Turkey.

Spinal epidural lipomatosis is a rare condition which is described as the accumulation of fat in the extradural territory and often causes dural impingement. Spinal epidural lipomatosis has been implicated in causing a variety of neurologic impairments ranging from back pain, radiculopathy, claudication, myelopathy or even cauda equina syndrome. We report a 46-year-old female with obesity and a history of chronic back pain and radiculopathy who developed idiopathic Spinal epidural lipomatosis diagnosed by magnetic resonance imaging. Read More

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May 2016
6 Reads

Posterior Epidural Migration of a Sequestrated Lumbar Disk Fragment Causing Cauda Equina Syndrome in an Old Patient: A Case Report.

Clin Med Insights Case Rep 2016 22;9:39-41. Epub 2016 May 22.

Department of Neurosurgery, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran.

Disk fragment relocation is commonly limited to the anterior epidural space, although posterior epidural movement of a sequestrated disk piece to the posterior epidural space is infrequent. We present an uncommon case of dorsal extradural sequestration of lumbar disk herniation. A 77-year-old man presented with severe leg pain, low back pain, and urinary incontinence. Read More

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http://dx.doi.org/10.4137/CCRep.S39139DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4877079PMC
June 2016
17 Reads

Idiopathic Spinal Epidural Lipomatosis in the Lumbar Spine.

Orthopedics 2016 May 29;39(3):163-8. Epub 2016 Mar 29.

Overgrowth of epidural fat, known as spinal epidural lipomatosis (SEL), can cause symptomatic compression of the spinal cord, conus medullaris, or cauda equina. Suggested predisposing factors such as obesity, steroid use, and diabetes mellitus have been based on a few reported cases, many of which were not surgically confirmed. There is a paucity of epidemiological data in surgically confirmed cases for this disorder. Read More

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http://www.healio.com/orthopedics/journals/ortho/%7B181eb994
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http://memo.cgu.edu.tw/cgmj/3206/320610.pdf
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http://homepage.vghtpe.gov.tw/~jcma/67/5/258.pdf
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http://dx.doi.org/10.3928/01477447-20160315-04DOI Listing
May 2016
20 Reads

Multiple myeloma presenting with acute bony spinal cord compression and mechanical instability successfully managed nonoperatively.

Spine J 2016 08 17;16(8):e567-70. Epub 2016 Mar 17.

Spinal Deformities Unit, Royal National Orthopaedic Hospital, Brockley Hill, Stanmore, Middlesex, HA7 4LP, UK.

Background Context: Multiple myeloma (MM) with spinal involvement may present with spinal cord or cauda equina compression, with or without neurological impairment. This occurs when a soft-tissue myelomatous mass extends into the epidural space (Barron et al., 1959 [1]). Read More

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http://dx.doi.org/10.1016/j.spinee.2016.03.011DOI Listing
August 2016
13 Reads

Evaluating the patient with low back pain.

Practitioner 2015 Dec;259(1788):21-4, 2-3

In the UK, low back pain is the most common cause of disability in young adults and every year 6-9% of adults consult their GP about back pain. A thorough history and examination is required to exclude an alternative diagnosis, such as pain arising from the hip or trochanteric bursa and to categorise patients as having: serious spinal pathology, nerve root/radicular pain or non-specific back pain. Inflammatory back pain is often missed, particularly in the early stages when examination may be normal. Read More

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December 2015
8 Reads

Lesson of the month 2: Cauda equina in Cushing's syndrome.

Clin Med (Lond) 2016 Feb;16(1):88-90

Medical Oncology, Addenbrooke's Hospital, Cambridge, UK.

We present the case of a 34-year old woman who initially presented with obesity and back pain. She was eventually diagnosed with Cushing's syndrome secondary to an adrenocortical carcinoma that had metastasised to her spine, causing cauda equina compression. The delays in reaching the correct diagnosis caused significant morbidity and exemplify the pitfalls of premature closing, a common cognitive error in diagnostic reasoning. Read More

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http://dx.doi.org/10.7861/clinmedicine.16-1-88DOI Listing
February 2016
9 Reads

A definition of "uncomplicated bone metastases" based on previous bone metastases radiation trials comparing single-fraction and multi-fraction radiation therapy.

J Bone Oncol 2015 Mar 23;4(1):13-7. Epub 2015 Jan 23.

Rapid Response Radiotherapy Program, Odette Cancer Centre, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada.

The most recent systematic review of randomized trials in patients with bone metastases has shown equal efficacy of single fraction (SF) and multiple fraction (MF) palliative radiation therapy in pain relief. It is important to determine the patient population to which the evidence applies. This study aims to examine the eligibility criteria of the studies included in the systematic review to define characteristics of "uncomplicated" bone metastases. Read More

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http://dx.doi.org/10.1016/j.jbo.2014.12.001DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4620946PMC
March 2015
11 Reads

Neuroprotective effect of hydrogen sulfide on acute cauda equina injury in rats.

Spine J 2016 Mar 30;16(3):402-7. Epub 2015 Oct 30.

Department of Orthopedics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, 639 Zhizaoju Rd, Shanghai 200011, China.

Background: Hydrogen sulfide (H2S), as a novel gaseous messenger molecule, plays an important role in signal transduction and biological modulation.

Purpose: In the present study the effect of H2S after compression injury of cauda equina was studied.

Study Design: The setting of this study is the laboratory investigation. Read More

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http://dx.doi.org/10.1016/j.spinee.2015.10.046DOI Listing
March 2016
17 Reads