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Objective: This case report discusses the diagnostic challenges associated with the early identification of cauda equina syndrome in a 25-year-old patient without lumbar spinal pain. It introduces a new classification scheme related to a more effective diagnosis.

Clinical Features: The patient experienced pain in the right hamstring, diagnosed as a pulled muscle.

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: Charcot-Marie-Tooth (CMT) disease is an inherited peripheral neuropathy primarily involving motor and sensory neurons. Mutations in INF2, an actin assembly factor, cause two diseases: peripheral neuropathy CMT-DIE (MIM614455) and/or focal segmental glomerulosclerosis (FSGS). These two phenotypes arise from the progressive degeneration affecting podocytes and Schwann cells.

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Intradural lumbar disc herniation (ILDH) is a very rare condition, with cerebrospinal fluid (CSF) leakage as a postoperative complication. The central canal of the conus medullaris was reported to communicate with the subarachnoid space through a caudal aperture; however, this aperture has never been observed in vivo. Herein, we report a case of L1/2 ILDH with postoperative spinal adhesive arachnoiditis and syringomyelia in which the communication considered to be a caudal aperture was detected.

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Intradural disc herniation (IDDH) is a rare condition, accounting for less than 0.5% of herniated disc cases, primarily affecting the lumbar region and often presenting with severe nerve compression or cauda equina syndrome. This paper presents the case of a 60-year-old female with a history of hypertension, dyslipidemia, stroke, and hypothyroidism, who arrived with severe lower back pain, lower limb weakness, and urinary retention.

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