Cauda Equina Syndrome Following Traumatic Penetrating Lumbar Injury Caused by A Small Leather Fragment

Abstract

Rarely, foreign material that has found its way into the spinal canal can migrate in the epidural space (posterior epidural migration), which usually causes radicular signs. Here, an uncommon case involving a patient with cauda equina syndrome due to posterior epidural migration of a leather piece is reported. The patient described in this report presented with an acute cauda equina syndrome (incontinence, paresis) resulting from the migration of a leather piece initially penetrating into the spinal column at the L3-L4 level. The leather piece was not observable either on magnetic resonance imaging or on computed tomography scanning and was found only through surgical exploration. Following laminectomy and removal of the leather piece, motor, sensory, and urological functions were recovered. At late follow-up, the patient was doing well after 6 months. It is difficult to diagnose preoperatively whether a small piece of foreign material could migrate to the posterior epidural space of the dural sac. Early intervention and surgery are necessary, which would lead to complete recovery.