Cauda equina syndrome

Case contributed by Dr Henry Knipe

Presentation

One day history of bilateral leg numbness and left foot drop with decreased perineal sensation.

Patient Data

Age: 30 years
Gender: Male
mri

Large L3/L4 central caudally directed disc extrusion resulting in severe central spinal canal stenosis with effacement of the CSF surrounding a compressed cauda equina.

No foraminal stenosis. No other intervertebral disc herniation. The remainder of the spinal canal is capacious.

Case Discussion

Cauda equina syndrome refers to a collection of symptoms and signs that result from severe compression of the descending lumbar and sacral nerve roots. It is considered a surgical emergency, and this patient proceeded to an L3/4 microdiscectomy and rhizolysis with the resolution of symptoms post-operatively. 

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