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Cauda equina

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https://www.readbyqxmd.com/read/28434102/outcomes-following-surgical-management-of-cauda-equina-syndrome-does-race-matter
#1
Amit Jain, Emmanuel Menga, Addisu Mesfin
Cauda equina syndrome (CES) is a surgical emergency requiring urgent spinal decompression. Our objective is to analyze the association between race and in-hospital outcomes (complications, mortality, length of stay, and discharge disposition) in patients with CES. This is a retrospective cohort study of CES patients identified via the Nationwide Inpatient Sample (NIS) from 2000 to 2010 in inpatient hospitalizations in the USA. The patient sample includes 46,017 patients ≥18 undergoing spine surgery for CES...
April 21, 2017: Journal of Racial and Ethnic Health Disparities
https://www.readbyqxmd.com/read/28423044/the-long-term-outcome-of-micturition-defecation-and-sexual-function-after-spinal-surgery-for-cauda-equina-syndrome
#2
Nina S Korse, Anna B Veldman, Wilco C Peul, Carmen L A Vleggeert-Lankamp
BACKGROUND: Cauda equina syndrome (CES) is a rare neurologic complication of lumbar herniated disc for which emergency surgical decompression should be undertaken. Despite the common belief that the restoration of functions that are affected by CES can take several years postoperatively, follow up seldom exceeds the first year after surgery. Long term outcome of especially micturition, defecation and sexual function-which are by definition affected in CES-are unknown. The aim of this study is to evaluate 1) postoperative long term outcome of micturition, defecation and sexual function in CES patients 2) attitude of patients towards received hospital care with regard to (recovery of) these functions...
2017: PloS One
https://www.readbyqxmd.com/read/28403681/atrophy-ultra-structural-disorders-severe-atrophy-and-degeneration-of-denervated-human-muscle-in-sci-and-aging-implications-for-their-recovery-by-functional-electrical-stimulation-updated-2017
#3
Helmut Kern, Cristian Hofer, Stefan Loefler, Sandra Zampieri, Paolo Gargiulo, Alfonc Baba, Andrea Marcante, Francesco Piccione, Amber Pond, Ugo Carraro
OBJECTIVES: Long-term lower motor neuron denervation of skeletal muscle is known to result in degeneration of muscle with replacement by adipose and fibrotic tissues. However, long-term survival of a subset of skeletal myofibers also occurs. METHODS: We performed transverse and longitudinal studies of patients with spinal cord injury (SCI), patients specifically complete Conus and Cauda Equina Syndrome and also of active and sedentary seniors which included analyses of muscle biopsies from the quadriceps m...
April 13, 2017: Neurological Research
https://www.readbyqxmd.com/read/28395115/the-brain-of-the-tree-pangolin-manis-tricuspis-i-general-appearance-of-the-central-nervous-system
#4
Aminu Imam, Moyosore S Ajao, Adhil Bhagwandin, Amadi O Ihunwo, Paul R Manger
Here we describe the superficial appearance of the brain of the rarely studied tree pangolin. Phylogenetic analyses have placed the pangolins, order Pholidota, as a sister group to the order Carnivora. The majority of features visible on the surface of the tree pangolin brain, and its overall appearance can be described as typically mammalian. The pattern of sulci and gyri, while simple, appears very similar to that observed in carnivores. Two derived features of the Pholidota were observed, the first being the rostral decussation of the pyramidal tract, which instead of occurring at the spinomedullary junction, decussates at the level of the caudal pole of the facial nerve nucleus in the rostral medulla oblongata...
April 10, 2017: Journal of Comparative Neurology
https://www.readbyqxmd.com/read/28385420/less-is-more-efficacy-of-rapid-3d-t2-space-in-ed-patients-with-acute-atypical-low-back-pain
#5
Nicholas A Koontz, Richard H Wiggins, Megan K Mills, Michael S McLaughlin, Elaine C Pigman, Yoshimi Anzai, Lubdha M Shah
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...
April 3, 2017: Academic Radiology
https://www.readbyqxmd.com/read/28383409/clinical-case-series-report-of-traumatic-cauda-equina-herniation-a-pathological-phenomena-occurring-with-thoracolumbar-and-lumbar-burst-fractures
#6
Liang Yan, Yang Liu, Baorong He, Jijun Liu, Zhenguo Luo, Dingjun Hao
RATIONALE: Burst fractures in thoracolumbar and lumbar spine typically occur from severe trauma, which may result in cauda equina herniation (CEH). In this study, we attempted to document the incidence and evaluate the sequelae of CEH that were found during decompression and fusion surgery for patients with burst fractures. PATIENT CONCERNS: A total of 416 patients were enrolled in this study. DIAGNOSES: The patients had been operated on through an anterior or posterior approach for treatments of thoracolumbar and lumbar burst fractures at our department between June 1, 2008 and June 1, 2011...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28374127/surgical-management-of-solitary-nerve-sheath-tumors-originating-around-the-epiconus-or-conus-medullaris-a-retrospective-case-analysis-based-on-neurological-function
#7
Kentaro Naito, Toru Yamagata, Atsufumi Nagahama, Shinichi Kawahara, Kenji Ohata, Toshihiro Takami
The objective of this retrospective case analysis was to evaluate the surgical impact on neurological functional recovery in cases of solitary spinal nerve sheath tumors (NSTs) originating around the epiconus, conus medullaris, or cauda equina and not associated with neurofibromatosis. This 10-year surgical study included 30 cases of spinal NSTs originating around the spine level of T12-L1 (epiconus-to-conus medullaris: Epi-CM group), and 15 cases of spinal NSTs originating below the spine level of L2 (cauda equina: CE group)...
April 3, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28361366/a-rare-invasive-hemangioma-in-cauda-equina
#8
Hongfei Xiang, Nana Shen, Bohua Chen, Xuexiao Ma, Gang Xin
PURPOSE: Typical hemangioma of cauda equina with relative clear margin has been described in some case reports, but atypical hemangioma with invasion, infiltration, and augmentation of all nerve roots in the cauda equina area has never been reported. In this paper, we reported a rare case with invasive hemangioma in cauda equina, and analyzed its radiological appearance and treatment. METHODS: We described an atypical case of hemangioma, which was revealed by MR and intraoperative photograph without clear margin and confirmed by histopathologic diagnosis...
March 30, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28359011/diagnostic-triage-for-low-back-pain-a-practical-approach-for-primary-care
#9
REVIEW
Lynn D Bardin, Peter King, Chris G Maher
Diagnostic triage is an essential guideline recommendation for low back pain (LBP), which is the most frequent musculoskeletal condition that general practitioners encounter in Australia. Clinical diagnosis of LBP - informed by a focused history and clinical examination - is the key initial step for GPs, and determines subsequent diagnostic workup and allied health and medical specialist referral. The goal of diagnostic triage of LBP is to exclude non-spinal causes and to allocate patients to one of three broad categories: specific spinal pathology (< 1% of cases), radicular syndrome (∼ 5-10% of cases) or non-specific LBP (NSLBP), which represents 90-95% of cases and is diagnosed by exclusion of the first two categories...
April 3, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28347895/metabolomic-changes-in-rat-model-of-cauda-equina-injury
#10
Yang Liu, Rui Yang, Qingjie Kong, Yuan Wang, Bin Zhang, Jingchuan Sun, Yong Yang, Bing Zheng, Hongbin Yuan, Jiangang Shi
BACKGROUND: To demonstrate the differences of metabolomic changes in a rat model of cauda equina injury (CEI) and find potent metabolic biomarkers of CEI. MATERIAL AND METHODS: A total of 28 Sprague-Dawley (SD) rats were used in this study. After the rats were given anesthesia and fixed in a prone position, a piece of silicone block was placed into the epidural space below the lamina. Behavior tests including the Basso, Beattie, and Bresnahan (BBB) open field locomotor scale and an inclined plane test were conducted 1 day and 2 days after surgery...
March 24, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28303206/post-irradiation-lumbosacral-radiculopathy-associated-with-multiple-cavernous-malformations-of-the-cauda-equina-case-report-and-review-of-the-literature
#11
Doniel Drazin, Ari Kappel, Stefan Withrow, Tiffany Perry, Ray Chu, Surasak Phuphanich
BACKGROUND: Multiple radiation-induced cavernous malformations of the cauda equina are extremely rare. A review of the literature suggested that the post-irradiation lumbosacral radiculopathy in our patient was most likely associated with a diagnosis of multiple radiation-induced cavernous malformations of the cauda equina. CASE DESCRIPTION: A 76-year-old man with a remote history of abdominal radiation therapy presented with a 6-month history of progressively worsening right foot drop and balance impairment...
2017: Surgical Neurology International
https://www.readbyqxmd.com/read/28286628/hemophagocytic-lymphohistiocytosis-an-unclear-nosologic-entity-case-report-of-an-adult-man-with-rising-of-amylase-and-lipase-and-spinal-cord-infiltration
#12
Moris Sangineto, Antonio Perrone, Pasquale Agosti, Viera Boccuti, Anna Campobasso, Carlo Sabbà
Here we present the case of a 57-years old patient affected by hemophagocytic lymphohistiocytosis (HLH), a rare disease characterized by an uncontrolled immune activation, resulting in clinical and biochemical manifestations of extreme inflammation. In a previous hospitalization, the patient showed fever, hepato-splenomegaly, pancytopenia, hyperferrtitinemia, lymphadenopathy and cholestasis. No diagnosis was done, however, he totally recovered after splenectomy. Eight months later, he relapsed, showing also hypofibrinogenemia, hypertriglyceridemia, hemophagocytic signs in bone marrow, cholestatic jaundice, high LDH and high PT-INR...
February 23, 2017: Hematology Reports
https://www.readbyqxmd.com/read/28285756/partial-cauda-equina-syndrome-after-an-uneventful-minimally-invasive-microdiscectomy-in-a-patient-with-crohn-s-disease
#13
C Raftopoulos, S Koenig, V Joris, T Duprez
Cauda equina syndrome is a serious condition resulting from dysfunction of the lumbosacral nerve roots and characterized by impairment of bladder, bowel, sexual and lower limb functions. We report the case of a 48-year-old woman who had Crohn's disease for more than twenty years. The patient was undergoing immunotherapy with infliximab and developed a partial cauda equina syndrome after an uneventful minimally invasive microdiscectomy (L5-S1) that completely cured her sciatica. A postoperative magnetic resonance imaging examination showed root clumping but no compressive lesion...
March 9, 2017: Neuro-Chirurgie
https://www.readbyqxmd.com/read/28259071/epidural-lipomatosis-with-cauda-equina-syndrome-in-chronic-alcoholic-patient-a-case-report
#14
Sung-Soo Kim, Dong-Ju Lim
INTRODUCTION: Epidural lipomatosis of the lumbar spine is a rare condition, which is described as the accumulation of fat in the extradural territory. PRESENTATION OF CASE: We report the case of a 60-year-old, non-obese, and chronic alcoholic man who was transferred to our spine department with cauda equina syndrome (CES) for 4 months. On magnetic resonance imaging (MRI), spinal epidural lipomatosis (SEL) was confirmed in the multilevel lumbar lesion. A decompression surgery was performed and the patient recovered significantly...
February 20, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28235527/a-patient-with-postpolio-syndrome-developed-cauda-equina-syndrome-after-neuraxial-anesthesia-a-case-report
#15
Wei-Cheng Tseng, Zhi-Fu Wu, Wen-Jinn Liaw, Su-Yang Hwa, Nan-Kai Hung
Combined spinal anesthesia and postoperative epidural analgesia is widely used in orthopedic surgery. Uncommon but serious neurologic complications of neuraxial anesthesia (NA) include direct trauma during needle or catheter insertion, central nervous system infections, and neurotoxicity of local anesthetics. Cauda equina syndrome (CES) is a rare complication after NA but can result in severe neurologic deterioration that may require surgical intervention. We present a case of a 69-year-old woman with postpolio syndrome who developed CES after combined spinal anesthesia and postoperative epidural analgesia...
February 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28228325/prognostic-factors-associated-with-the-surgical-indication-for-lumbar-spinal-stenosis-patients-less-responsive-to-conservative-treatments-an-investigator-initiated-observational-cohort-study
#16
Masayoshi Fukushima, Hiroyuki Oka, Nobuhiro Hara, Yasushi Oshima, Hirotaka Chikuda, Sakae Tanaka, Katsushi Takeshita, Ko Matsudaira
BACKGROUND: A few cohort studies have determined which patients with lumbar spinal stenosis are likely to need surgery because of the deterioration of symptoms. However, there are still insufficient data regarding the management of lumbar spinal stenosis due to lack of prognostic factors associated with the need for surgery. The purpose of this study was to identify the prognostic factors associated with the need for surgical treatment in patients with lumbar spinal stenosis. METHODS: Patients with lumbar spinal stenosis from our hospital and related facilities were enrolled...
February 19, 2017: Journal of Orthopaedic Science: Official Journal of the Japanese Orthopaedic Association
https://www.readbyqxmd.com/read/28216208/a-rare-case-of-pediatric-lumbar-spinal-ependymoma-mimicking-meningitis
#17
Ezeali Mike Ekuma, Kiyoshi Ito, Akihiro Chiba, Yosuke Hara, Kohei Kanaya, Tetsuyoshi Horiuchi, Samuel Ohaegbulam, Kazuhiro Hongo
Spontaneous acute subarachnoid hemorrhage (SAH) from lumbar ependymoma in children is rare. We report a case of a 14-year-old boy who developed sudden radicular low back pain while playing baseball. He was initially managed conservatively in a local hospital for suspected lumbar disc herniation, but he later developed meningeal symptoms and fever before being referred to our hospital. He underwent a diagnostic lumbar puncture in the emergency department; his cerebrospinal fluid suggested an SAH. Physical examination showed meningeal signs and cauda equina features...
April 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28195228/ejaculation-and-sperm-characteristics-in-men-with-cauda-equina-and-conus-medullaris-syndromes
#18
N Hadiji, R Mieusset, J G Previnaire, E Castel-Lacanal, J M Soler
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. METHODS: One hundred sixty-six patients with CE and CM lesions were included. Diagnosis was based on clinical (no motor responses, sensation or sacral reflexes) and urodynamic assessments (no detrusor activity)...
February 14, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28178992/percutaneous-transforaminal-endoscopic-surgery-ptes-for-symptomatic-lumbar-disc-herniation-a-surgical-technique-outcome-and-complications-in-209-consecutive-cases
#19
Yu-Tong Gu, Zhan Cui, Hong-Wei Shao, Yun Ye, Ai-Qun Gu
BACKGROUND: We designed an easy posterolateral transforaminal endoscopic decompression technique, termed PTES, for radiculopathy secondary to lumbar disc herniation. The purpose of the study is to describe the technique of PTES and evaluate the efficacy and safety for treatment of lumbar disc herniation including primary herniation, reherniation, intracanal herniation, and extracanal herniation and to report outcome and complications. METHODS: PTES was performed to treat 209 cases of intracanal or extracanal herniations with or without extruding or sequestrated fragment, high iliac crest, scoliosis, calcification, or cauda equina syndrome including recurrent herniation after previous surgical intervention at the index level or adjacent disc herniation after decompression and fusion...
February 8, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28164059/neuropathic-knee-joint-a-complication-of-syrinx-following-spinal-anesthesia-a-rare-case-report-and-review-of-literature
#20
S Swaroop Chandra, J K Giriraj Harshavardhan, Ganesan G Ram, P V Vijayaraghavan
INTRODUCTION: Neurological complications due to spinal anesthesia are dysesthesia, paresthesia, cauda equina syndrome, and neuropathic joint. However, neurological complications are rare. We report a case of neuropathic joint of knee as a complication of syrinx following postspinal anesthesia. CASE REPORT: A 33-year-old female came with complaints of pain and instability of her left knee and left foot drop. She had developed weakness of her left lower limb following her cesarean section surgery done under spinal anesthesia...
September 2016: Journal of Orthopaedic Case Reports
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