The authors report a clinical and radiological observation of cauda equina syndrome associated with ankylosing spondylitis. Although only 32 cases have been reported in the literature over the last twenty years, such an association is probably not exceptional. The mode of onset and the course of the neurological symptoms is quite similar from case to case: ankylosing spondylitis preexisting for many years, and inactive when neurological signs develop, the latter usually being very slowly progressive. The usual radiological features, demonstrated by saccoradiculography in the supine position, are posterior diverticulas of the lumbar theca, contiguous to bony erosions of the laminae, well visualized by computed tomography. Pathogenesis remains obscure, and none of the attempted therapies, including surgical procedures, have proved effective.
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Orthop Surg
January 2025
Department of Orthopedics, Ningbo No. 6 Hospital, Ningbo, Zhejiang, China.
Background: Postoperative spinal epidural hematoma (SEH) is a rare but serious complication following lumbar surgery, with cauda equina syndrome (CES) being one of its most devastating outcomes. While CES typically presents with a combination of bladder and/or bowel dysfunction, diminished sensation in the saddle area, and motor or sensory changes in the lower limbs, atypical cases with isolated urinary symptoms are less recognized and pose significant diagnostic challenges.
Case Presentation: We report the case of a 46-year-old male who developed CES following lumbar microdiscectomy, presenting solely with urinary retention, without the classic signs of lower limb weakness or perineal sensory loss.
BMC Musculoskelet Disord
January 2025
Chinese People's Armed Police Force Special Medical Center, Tianjin, 300300, China.
Background: Lumbar burst fracture combined with lamina fracture is a special type of spinal fracture. Neither CT nor MRI can accurately determine it. The present study aims to investigate the clinical value of 3D CT/MRI fusion imaging in the treatment of lumbar burst fracture complicated with lamina fracture.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Division of Neurosurgery, Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, 2 Wang Lang Road, Bangkok Noi, 10700, Bangkok, Thailand.
Treatment of neuropathic pain in patients with spinal cord injury (SCI) and cauda equina injury (CEI) remains challenging. Dorsal root entry zone lesioning (DREZL) or DREZotomy is a viable surgical option for refractory cases. This study aimed to compare DREZL surgical outcomes between patients with SCI and those with CEI and to identify predictors of postoperative pain relief.
View Article and Find Full Text PDFNeuroSci
December 2024
Laboratory of Surgical Neuroanatomy (LSNA), Human Anatomy and Embryology Unit, Faculty of Medicine and Health Sciences, Universitat de Barcelona, 08036 Barcelona, Spain.
Cauda equina nerve roots may become damaged during neuraxial anesthesia, and post-puncture headache may appear in the case of cerebrospinal fluid leakage if needle tips are deformed due to bone contact when several attempts are needed. Our aim was to verify the correlation between skin-transverse process distance (st) and skin-dural sac distance (d) for calculation of optimal angles in a free visual guide and as a reference for the maximal depth to be traversed by the needle. Randomly selected ex vivo samples ( = 10) were flexed to reproduce the position of the lumbosacral spine during spinal anesthesia.
View Article and Find Full Text PDFCurr Oncol
November 2024
Department of Medicine and Surgery, Kore University of Enna, 94100 Enna, Italy.
(1) Background: Testicular cancer, although accounting for only 0.5% to 1% of all solid male cancers, is the most common malignancy in males aged 15 to 35 years. Non-seminomatous germ cell tumors (NSGCT) represent nearly half of all testicular germ cell tumors and are associated with a more aggressive clinical course.
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