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Cauda equina

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https://www.readbyqxmd.com/read/28720993/inserting-pedicle-screws-in-lumbar-spondylolisthesis-the-easy-bone-conserving-way
#1
Hitesh Lal, Lalit Kumar, Ramesh Kumar, Tankeshwar Boruah, Pankaj Kumar Jindal, Vinod Kumar Sabharwal
BACKGROUND: Pedicle screw fixation in high grade lumbar listhetic vertebral body has been nightmare for Orthopaedic and spine surgeons. This is because of abnormally positioned listhetic pedicles and non-visualization of pedicle in conventional image intensifier (C-Arm). This results into increased surgical time, more blood loss, radiation exposure and more chances of infection. To overcome this problem, we have devised a new Technique of putting of pedicle screw fixation in listhetic vertebrae...
April 2017: Journal of Clinical Orthopaedics and Trauma
https://www.readbyqxmd.com/read/28718233/haemodynamic-preservation-in-caesarean-sections-by-low-dose-0-5-hyperbaric-bupivacaine
#2
Maqsood Ahmad, Mumtaz Ahmad, Naveel Atif
BACKGROUND: Spinal anaesthesia is technique of choice for caesarean sections and hyperbaric bupivacaine is a recommended drug for this popular block. Although safe but few complications are haemodynamic changes, postdural puncture headache, cauda equina syndrome and radiculopathy. However, hypotension remains the common side effect which is believed to occur in 95% of patients resulting in reduction of uteroplacental perfusion causing foetal acid-base abnormalities. Various doses regimes are in safe anaesthesia practice for providing regional anaesthesia for such patients with least detrimental effects on foetal outcome...
April 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/28708042/editorial-use-of-anterior-lumbar-discectomy-and-interbody-fusion-in-the-management-of-recurrent-lumbar-disc-herniation-and-cauda-equina-syndrome
#3
Paul M Arnold
No abstract text is available yet for this article.
July 14, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28708040/anterior-lumbar-discectomy-and-fusion-for-acute-cauda-equina-syndrome-caused-by-recurrent-disc-prolapse-report-of-3-cases
#4
Kimberly-Anne Tan, Mathew D Sewell, Yma Markmann, Andrew J Clarke, Oliver M Stokes, Daniel Chan
There is a lack of information and consensus regarding the optimal treatment for recurrent disc herniation previously treated by posterior discectomy, and no reports have described an anterior approach for recurrent disc herniation causing cauda equina syndrome (CES). Revision posterior decompression, irrespective of the presence of CES, has been reported to be associated with significantly higher rates of dural tears, hematomas, and iatrogenic nerve root damage. The authors describe treatment and outcomes in 3 consecutive cases of patients who underwent anterior lumbar discectomy and fusion (ALDF) for CES caused by recurrent disc herniations that had been previously treated with posterior discectomy...
July 14, 2017: Journal of Neurosurgery. Spine
https://www.readbyqxmd.com/read/28705774/asia-a-sensory-and-motor-complete-is-not-different-than-asia-b-sensory-incomplete-motor-complete-in-gunshot-related-spinal-cord-injury
#5
Eric McCoy, Nima Eftekhary, Kenneth Nwosu, Dudley Fukunaga, Charles Liu, Kevin Rolfe
Background Context We receive a large number of spinal cord injury (SCI) patients due to penetrating gunshot wounds (GSW) at our national rehabilitation center. Though many patients are labeled American Spinal Injury Association (ASIA) B sensory incomplete due to sensory sparing, especially deep anal pressure, with purported prognostic value, we have not observed a clinical difference from ASIA A completes. We hypothesized that sensory sparing, if meaningful, should reduce the occurrence of pressure ulcers...
July 10, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28705700/incidental-primary-intradural-carcinoid-tumor-in-a-patient-with-lumbar-radiculopathy
#6
Stavros Koustais, Philip O'Halloran, Alfrazdaq Hassan, Francesca Brett, Steven Young
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, as well as primary skeletal or extradural disease resulting in compressive myelo-radiculopathy. There are two previously reported cases of primary intradural extramedullary carcinoid tumor, presenting with compressive symptoms. We report the first case of primary incidental intradural extramedullary carcinoid tumor...
July 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28676364/neurogenic-pelvic-pain
#7
REVIEW
Nicholas Elkins, Jason Hunt, Kelly M Scott
Pelvic neuralgias frequently cause severe pain and may have associated bladder, bowel, or sexual dysfunctions which also impact quality of life. This article explores the etiology, epidemiology, presentation and treatment of common causes of neurogenic pelvic pain, including neuralgia of the border nerves (ilioinguinal, iliohypogastric, and genitofemoral), pudendal neuralgia, clunealgia, sacral radiculopathies caused by Tarlov cysts, and cauda equina syndrome. Treatment of pelvic neuralgia includes conservative measures such as pelvic physical therapy, lifestyle modification, and medications with escalation to more invasive and novel treatments such as nerve blocks, radiofrequency ablation, cryoablation, neuromodulation and neurectomy/neurolysis if conservative treatments are ineffective...
August 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/28664010/spontaneous-regression-of-inflammatory-pseudotumor-in-the-cauda-equina-a-case-report
#8
Kazuhiro Yoshimura, Manabu Sasaki, Masaru Kojima, Kouichirou Tsuruzono, Katsumi Matsumoto, Akatsuki Wakayama, Toshiki Yoshimine
Spinal intradural extramedullary inflammatory pseudotumor (IPT) is an extremely rare entity. Spontaneous shrinking of a spinal IPT has never been reported. A case of an IPT of the cauda equina that regressed spontaneously is presented. A 78-year-old woman presented with hypoesthesia of both lower legs in the L4 nerve root distribution and motor weakness of the right leg. Preoperative CT myelography and MRI showed two tumor-like lesions located at T12-L1 and L2-3. The lesion at the T12-L1 level appeared to encase several nerve roots...
October 2016: NMC Case Rep J
https://www.readbyqxmd.com/read/28658038/immediate-versus-delayed-surgical-treatment-of-lumbar-disc-herniation-for-acute-motor-deficits-the-impact-of-surgical-timing-on-functional-outcome
#9
Ondra Petr, Bernhard Glodny, Konstantin Brawanski, Johannes Kerschbaumer, Christian Freyschlag, Daniel Pinggera, Rafael Rehwald, Sebastian Hartmann, Martin Ortler, Claudius Thomé
STUDY DESIGN: A retrospective cohort study. OBJECTIVE: The aim of the study was to assess the impact of time to surgery in patients with MDs on their functional outcome. The current single-center study presents results of emergency surgery for LDH in a group of patients with acute paresis in a "real-world" setting. SUMMARY OF BACKROUND DATA: Motor deficits (MDs) are a frequent symptom of lumbar disc herniation (LDH). While surgery within 48 hours has been recommended for cauda-equina syndrome, the best timing of surgery for acute MDs continues to be debated...
June 27, 2017: Spine
https://www.readbyqxmd.com/read/28653638/neisseria-meningitidis-subdural-empyema-causing-acute-cauda-equina-syndrome
#10
Olivia C Smibert, Olga Vujovic, Jennifer Hoy
No abstract text is available yet for this article.
July 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28652808/persistent-cauda-equina-syndrome-after-caudal-epidural-injection-under-severe-spinal-stenosis-a-case-report
#11
Young Tak Seo, Hyun Ho Kong, Goo Joo Lee, Heui Je Bang
Caudal epidural injection (CEI) is one of the most common treatments for low-back pain with sciatica. CEI rarely leads to neurologic complications. We report a case of persistent cauda equina syndrome after CEI. A 44-year-old male patient with severe L4 and L5 spinal ste-nosis underwent CEI for low-back pain and sciatica. The CEI solution consisted of bupivacaine, hyaluronidase, triamcinolone acetonide, and normal saline. He experienced motor weakness and sensory loss in both lower extremities and neurogenic bladder for more than 1 year after the procedure...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28637119/disco-vertebral-osteomyelitis-causing-intradural-spinal-abscess-with-cauda-equina-compression
#12
Anan Shtaya, Samantha Hettige
Intradural extramedullary spinal infections causing cauda equina compression are uncommon. We report an Escherichia coli bacteraemia causing lumbar discitis and an intracanalicular collection compressing the cauda equina: initially thought to be an epidural empyema, however microsurgery revealed an intradural location. Decompression, drainage, antibiotics, and neuropathy treatment are essential management.
March 3, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28637116/neurosurgeon-or-spinal-surgeon-who-should-treat-cauda-equina-syndrome
#13
Christopher James Andrew Cowie, Jonathan Richard Ellenbogen
Suspected cauda equina syndrome (CES) requires urgent evaluation, investigation and treatment. Timing of cauda equina decompression is crucial, and delays in its management, leading to significant irreversible disability can be devastating for patient and surgeon alike. The standard of care in CES therefore needs to be clear and unambiguous. Todd and Dickson have written an excellent paper summarising the condition, and have outlined what they feel is the standard of care. We would ask the authors to clarify an important point...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28637110/guidelines-for-cauda-equina-syndrome-red-flags-and-white-flags-systematic-review-and-implications-for-triage
#14
Nicholas V Todd
INTRODUCTION: Patients with cauda equina syndrome (CES) are frequently referred late when neurological damage cannot be reversed. National Guidelines for emergency referral, imaging and treatment of CES contain symptoms and/or signs that are those of late often, irreversible CES. Referral at this stage may be too late for that patient. METHODS: Seven sources were reviewed. Advice re emergency referral/imaging/treatment were reviewed. Symptoms/signs were compared with a standard classification of CES...
March 2, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28633540/benign-ependymoma-with-extensive-intracranial-and-spinal-cerebrospinal-fluid-dissemination-case-report-and-literature-review
#15
Fangmei Zhu, Jurong Ding, Yumei Li, Dewang Mao, Xianglei He, Wanyuan Chen, Lin Lou, Zhongxiang Ding
Myxopapillary ependymoma (MPE) is a rare variant of ependymoma that is most commonly located in the cauda equina and filum terminale. We present a case of 23-year-old man diagnosed with MPE in the fourth ventricle and sacral canal area with extensive disseminated lesions along the cerebrospinal ventricular system. Additionally, a molecular pathological diagnosis was performed. The patient underwent a craniotomy and a lumbar laminectomy. In the course of 18 months of follow-up, the patient have recovered very well...
June 21, 2017: British Journal of Neurosurgery
https://www.readbyqxmd.com/read/28596202/persistent-lesion-hyperintensity-on-brain-diffusion-weighted-mri-is-an-early-sign-of-intravascular-lymphoma
#16
Takashi Kageyama, Haruo Yamanaka, Fumihiko Nakamura, Toshihiko Suenaga
A 63-year-old man presented with right-sided hemianopia and unsteady gait. Brain MRI revealed multiple hyperintense infarct-like lesions on diffusion-weighted images (DWI). Hyperintensity persisted in some of these lesions even after 6 weeks, although his symptoms were ameliorated then. The patient developed episodic dizziness and a transient event of apraxia at 18 weeks after the first episode. Brain MRI revealed additional hyperintense lesions on DWI, which persisted even after 7 weeks. Eventually, the patient manifested cauda equina syndrome 39 weeks after the first episode...
June 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28580360/complete-cranial-iliac-osteotomy-to-approach-the-lumbosacral-foramen
#17
Barbara Dyall, Hugo Schmökel
An approach using a complete cranial iliac osteotomy (CCIO) to access the lumbosacral (LS) foramen in dogs from lateral was developed using cadavers and applied in a clinical patient with degenerative lumbosacral stenosis (DLSS). The foraminal enlargement in the cadavers and the patient was documented on postoperative CT scans. The preoperative CT scan of the patient showed moderate cranial telescoping of the sacral roof and a moderate central disk protrusion, leading to moderate to severe compression of the cauda equina...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28578526/the-rising-root-sign-the-magnetic-resonance-appearances-of-post-operative-spinal-subdural-extra-arachnoid-collections
#18
A Bharath, O Uhiara, Rajesh Botchu, A M Davies, S L James
We present a case series of symptomatic post-operative spinal subdural extra-arachnoid collections that displace the cauda equina roots anteriorly. This is described as the "rising root sign".
September 2017: Skeletal Radiology
https://www.readbyqxmd.com/read/28570879/acute-onset-of-paraganglioma-of-filum-terminale-a-case-report-and-surgical-treatment
#19
Domenico Murrone, Bruno Romanelli, Giuseppe Vella, Aldo Ierardi
INTRODUCTION: Paragangliomas of filum terminale are rare benign tumors, arising from the adrenal medulla or extra-adrenal paraganglia. These lesions usually present with chronic back pain and radiculopathy and only two cases of acute neurological deficit have been reported in literature. PRESENTATION OF CASE: A case with an acute paraplegia and cauda equina syndrome due to an hemorrhagic paraganglioma of the filum terminale is described. Magnetic resonance imaging showed an intradural tumor extending from L1 to L2 compressing the cauda equina, with an intralesional and intradural bleed...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28566787/acute-flaccid-paraparesis-cauda-equina-syndrome-in-a-patient-with-bardet-biedl-syndrome
#20
Vibhu Krishnan Viswanathan, Rishi Mugesh Kanna, Ajoy Prasad Shetty, S Rajasekaran
Bardet-Biedl syndrome (BBS) is a rare, autosomal-recessive, debilitating genetic disorder, which can present with multitudinous systemic clinical features including rod-cone dystrophy, polydactyly, Frohlich-like central obesity, mental retardation, hypogonadism, and renal anomalies. Diverse neuromuscular manifestations in patients afflicted by this heterogeneous disorder include ataxia, cervical, and thoracic canal stenoses, presenting as spastic quadriparesis and other gait disturbances. We report a young patient with BBS, who had presented with acute flaccid paraparesis due to severe primary lumbar canal stenosis...
May 2017: Indian Journal of Orthopaedics
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