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U2713 The authors explore an instance of arachnoiditis ossificans of the cauda equina. Although clustered arachnoidal cells are generally involved in its pathogenesis, an environment induced by arachnoiditis and impaired cerebrospinal fluid flow seems to be a more significant factor. For AO, no appropriate therapy currently exists, a therapeutic approach is suggested.
Source link: https://doi.org/10.3171/spi.2002.97.2.0239
Objects Based on myelography's findings Last reports of missing nerve roots of the cauda equina have limited to myelography analyses. Neither the imaging nor the clinical characteristics of RNRs in connection with magnetic resonance imaging have been elaborated. Results There were 16 patients in Group A, 14 in Group B, and 14 in Group C in terms of preoperative clinical signs, with a significant difference between Groups A and C in terms of leg pain and tingling sensation. In ambulatory capability, significant differences were also noted between Groups A and C, as well as between Groups B and C. A significant difference between Groups A and C in ambulatory capacity was found by evaluation of postoperative clinical results. Patients with MR imaging evidence of RNRs had more frequent clinical signs.
Source link: https://doi.org/10.3171/spi-07/07/027
There is a lack of information and consensus among the most effective treatment for chronic disc herniation treated by posterior discectomy, and no studies have reported an anterior strategy for recurrent disc herniation cauda equina syndrome. In three cases of patients who underwent anterior lumbar discectomy and fusion for CES caused by persistent disc hernias that had never been treated with posterior discectomy, the authors explore the causes and effects. In all three cases, complete recovery of herniated disc material was made without the presence of significant epidural scar tissue. No perioperative infection or neurological injury occurred, and all three patients had neurological recovery, with bladder and bowel function reactivation as well as leg pain relief. CES caused by persistent lumbar disc prolapse that was previously treated with posterior discectomy is one alternative to address CES caused by recurrent lumbar disc prolapse.
Source link: https://doi.org/10.3171/2017.1.spine16352
Epidural varicosis is a rare but well-known cause of cauda equina syndrome. Although inferior vena cava obstruction is the most common finding in those situations, portal vein hypertension can lead to epidural plexus engorgement by means of lumbar portocaval shunt activation. Therefore, a complete diagnostic study was done and revealed deep vein thrombosis, pulmonary embolism, and portal vein thrombosis. This is the first report of CES secondary to epidural varicosis in the case of acute portal vein thrombosis and extrahepatic portal vein obstruction, according to the authors' understanding.
Source link: https://doi.org/10.3171/2020.6.spine20625
Cauda equina ependymoma is a rare tumor for which no data is available regarding patient oncologic and medical outcomes. METHODS The medical records of 125 patients who underwent surgery between January 1998 and September 2018 were reviewed by a specialist. RESULTS On admission, 84% of patients had a McCormick grade of I, and 78. 8% had a Kesselring score of 0. Poor functional performance at discharge was predicted by sacral level involvement and tumor size. Poorer outcomes were associated with a preoperative McCormick grade u2265 III and Kesselring grade u2265 2 as a result. Pendymoma in Myxopapillary was more frequent than grade II ependymoma. The overall incidence of gross-total resection was 91. 2%, with higher incidences among patients with EII and MPE compared to those with MPE. The only factor associated with GTR on multivariate analysis was the presence of a capsule. The only factor that was linked to recurrence and the number of surgeries was the extent of resection. At a follow-up, a higher percentage of EIIIII than MPE patients was disease-free. QOL findings were poor in almost all areas compared to a control group of subjects from the Italian general population. CONCLUSIONS An early diagnosis of CEE is vital because larger tumors are related to recurrences and worse functional neurological outcomes. The histological subtype was not specifically related to recurrences, but some of the MPEs' most common features were listed. In most cases, the results are favorable, but the mean QOL perception is inferior to that of the general population.
Source link: https://doi.org/10.3171/2021.5.spine202049
OBJECTIVE Neurolymphomatosis is a rare symptom of lymphoma restricted to the peripheral nervous system that is poorly understood. METHODS The authors found cases of cauda equina NL with sufficient imaging to diagnose the lumbosacral plexus diagnosed from tissue biopsy using the Mayo Clinic medical records database. RESULTS: Ten patients met inclusion and exclusion criteria, and only 2 of ten patients developed cauda equina symptoms at the time of biopsy, with one patient undergoing a cauda equina biopsy. 2 The tumor cells grow into the spinal canal by corresponding neural foramina and propagate along the spinal nerves composing the cauda equina. Tumor cells can spread circumdurally to the opposite side of the spinal canal and into contralateral nerve roots, expanding both proximally and distally infiltrate the cauda equina.
Source link: https://doi.org/10.3171/2021.4.spine21344
Background Neuromyelitis optica is a demyelinating disease of the CNS that mostly affects the spinal cord and optic nerves. According to reports of NMOSD in the setting of cancer, aquaporin-4 autoimmunity may have a paraneoplastic basis. Here, we introduce a patient with metastatic sarcoma who tested positive for aquaporin-4 IgG consistent with NMOSD. Design/Methods A 66-year-old man with left thigh soft tissue sarcoma with metastasis to the lungs, who died after a 2-day history of urinary retention was accepted. Cord swelling with expansion from C6 to the thoracic spine was shown by MRI spine enhancement, which culminated in syringohydromyelia and diffuse enhancement of the cauda equina. In addition, sarcoma is uncommon cause of paraneoplastic syndromes, and, to our knowledge, this is the first report of sarcoma being associated with paraneoplastic NMOSD.
Source link: https://doi.org/10.1212/01.wnl.0000903524.66021.04
Introduction: Although magnetic resonance imaging is the most common imaging technique for determining cauda equina syndrome, a computerized tomography myelogram can be used in patients who are unable to perform MRI. Case Report: We present the case of a 38-year-old man who underwent surgical decompression for CES and developed an iatrogenic CSF leak from a pre-operative CT myelogram, resulting in recurrent thecal sac compression that necessive repeat surgery and dural repair.
Source link: https://doi.org/10.13107/jocr.2022.v12.i09.3002
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