Síndrome de cola de caballo secundario a hernia discal

Abstract

Introduction: cauda equina syndrome (CES) is a rare entity, caused by compression of the nerve roots in the spinal canal at the cauda equina level. It can leave serious sequelae if it is not diagnosed and treated early. Only 2-6% of lumbar disc herniation will cause CES. The diagnosis of this pathology is based on clinical criteria, these being the subject of controversy given the variability of presentation of the clinical picture.Materials and methods: we conducted a retrospective study. The target population are the patients operated on for CES secondary to herniated disc between January 2009 and December 2018 by a team from CE.DEF.CO. (center for spinal deformities). The objective is to carry out a set-up regarding the clinical presentation of this entity and to evaluate the correlation between surgical time and neurological improvement. Out of 20 patients who were operated, 17 (85%) presented urinary symptoms, 18 (90%) were patients in pain or presenting deficit elements in the lower limbs, 13 were cases of anesthesia / hypoesthesia in the saddle, 6 cases evidenced intestinal symptoms and 3 cases presented sexual dysfunction. In 19 cases, a surgical procedure was performed before 48 hours after symptoms started.Results: the remission of sphincter symptoms after one month is 83% and it rises to almost 87% one year after the surgery. One case of sexual dysfunction persisted one year after surgery.Conclusion: early diagnosis by the emergency physician is essential, so knowledge of this pathology is essential. Our experience and good results allow us to conclude that early surgical treatment is associated with symptomatic improvement and fewer neurological sequelae in the short and long term.