Cauda equina syndrome in a 32-year-old woman following an L5-S1 central lumbar disc herniation

Abstract

A 32-year-old woman with a history of chronic low back pain, hypertension, and urinary retention presented to the emergency department with left hip pain radiating to the posterior thigh, medial leg, and foot. Three days after admission, she developed cauda equina syndrome (CES) with decrease in left leg strength and sensation, as well as urinary and rectal incontinence. She was found to have a midline and left paracentral L5–S1 disc herniation on MRI and was taken to the operating room, where an L5–S1 hemilaminectomy and discectomy was performed. Her function improved almost immediately, and continued to improve after discharge from the hospital. In this report, we present a review of the literature on CES and focus on the relation between timing of surgery after the onset of CES and functional outcome.