TANDEM COMPRESSION OF MEDULLASPINALIS AND CAUDAEQUINA

Abstract

Objective: To analyze and present cases of tandem compression of medulla spinalis and cauda equina. Material and Methods: The subjects of observation were four patients with simultaneous compression of medulla spinalis and cauda equina, admitted to the Neurosurgery Clinic of the St George University Hospital, Plovdiv, Bulgaria during the period March 2012 — March 2014. The average age of the patients was 60.5 years (47–72). In one case, left-sided paramedian herniated discs were found at levels L1–2 and L4–5 combined with a concomitant stenosis, in another case — right-sided paramedian herniated discs on the level of Th12 — L1 and a degenerative stenosis at level of L3–4, in the third case — pronounced degenerative compression at level Th7–8 and a central stenosis at level of L4–5, and in the last case — degenerative stenosis at level L3–5 and spinal meningioma at level Th9–10. Results: The clinical signs of the simultaneous compression of the spinal cord and cauda equina have been examined. These signs may mislead the physician in the diagnosis of the spinal lesion, thus, resulting in inappropriate surgical strategy. Conclusion: The involvement of the spinal cord must be clinically confirmed to rule out lesions in the thoracic region. When the lumbar imaging examinations are inconclusive or cannot explain the clinical symptoms of a certain patient, it is advisable to perform a magnetic resonance imaging of the entire spine. Key words: tandem compression, spinal tumor, thoracic stenosis, lumbar stenosis.