Non-traumatic cauda equina syndrome in adults. What etiology? About 76 cases.

Abstract

Cauda equina syndrome is a rare neurological disease caused by compression of the cauda equina. The ponytail consists of the spinal nerves L2-L5, S1-S5 and the coccygeal nerve. We carried out a retroprospective study over a period of two years (24 months), ranging from January 01, 2020 to December 31, 2021 from the files of patients referred for lombosacral magnetic resonance imaging (MRI) or CT scan exploration in the context of low back pain or sciatica resistant to disabling medical treatment, neurological deficit of the lower limbs associated or not with the bladder and / or rectal sphincter disorders, without any notion of trauma, with as judgment criterion the demonstration of an anomaly responsible for compression of the roots of the ponytail. We collected seventy-six (76) patients, with an average age of 53.5 years old and as extremes ages 15 years and 89 years. We noted a female predominance with a sex ratio of 1.5 in favor of female sex. The most of patients were axplored with MRI, in 89 % of cases. Our patient history was dominated by cancer pathologies, with breast cancer in 24% of cases and prostatic cancer in 18% of cases. The symptomatology presented by the patients was mainly represented by sphencteric disorders in 47% of cases and lumboscialitica in 28% of cases. The conflicting disc herniation dominated the etiologies in 36 % of cases followed by secondary vertebral neoplasic lesions in 20% of cases . MRI and CT scans are very important radiological modalities in characterizing lesions responsible for cauda equina syndrome in adults. The CT scan is effective in the study of bone and the MRI in the study of nerve roots, intervertebral discs and paravertebral soft tissues.