Cauda Equina Compression Syndrome Research Articles

MR‐IMAGING OF LUMBOSACRAL INTERVERTEBRAL DISC DEGENERATION IN CLINICALLY SOUNDGERMAN SHEPHERD DOGS COMPARED TO OTHER BREEDS

German shepherd dogs are overrepresented in the group of dogs with cauda equina compression syndrome due to degenerative lumbosacral stenosis. A congenital predisposition for early degeneration of the lumbosacral intervertebral disc has been suspected. Our aims were to assess the morphologic appearance of the lumbosacral intervertebral disc and the lumbosacral junction in healthy German shepherd dogs compared to other breeds and to evaluate for an early onset of degenerative changes. The lumbosacral spine of 110 clinically sound German shepherd dogs and 47 healthy dogs of other large breeds was examined using magnetic resonance (MR) imaging. The degeneration of every intervertebral disc was graded using an established classification system. Signal intensity of the entire lumbosacral disc and the nucleus pulposus was determined independently. Lumbosacral malalignment was assessed according to a previously described method. The findings for the German shepherd dogs were compared to those of the other breeds. Although most dogs were younger than 18 months at the date of examination, significantly higher grades of degeneration were detected for the lumbosacral intervertebral disc of German shepherd dogs (P < 0.003). Degeneration of the lumbosacral intervertebral disc was independent from findings in the other lumbar discs. We conclude that the German shepherd dog has a predisposition for degenerative changes in the lumbosacral intervertebral disc.

Transient cauda equina compression syndrome and headache caused by internal vertebral venous plexus engorgement in a teenage female with vena cava inferior agenesis and iliac vein thrombosis

The internal vertebral venous plexus (IVVP) is part of the vertebral venous system (VVS). This system is the main alternative venous pathway, which joins, parallels but at the same time...

Synovial Cysts Associated with Cauda Equina Syndrome in Two Dogs

To report synovial cysts associated with cauda equina syndrome in 2 dogs. Clinical cases. Two German Shepherd dogs. After magnetic resonance imaging detection, cysts were surgically removed via dorsal laminectomy. Six and 8 months after surgery, both dogs were free of clinical signs and no pain was elicited on lumbosacral joint manipulation. Although described in dogs, cysts at the lumbosacral joint might cause compression of the cauda equina nerve roots. Radical excision of the cyst capsule can result in resolution of clinical signs. Synovial cysts should be considered in the differential diagnosis of dogs with cauda equina compression syndrome when lumbosacral degenerative joint disease is present.

Symptomatic Epidural Hematoma Caused by Lumbar Synovial Cyst Rupture: Report of Two Cases and Review of the Literature

Juxtafacet cysts of the lumbar spine are a recognized cause of back pain, radicular symptoms, neurogenic claudication, and, less often, cauda equina compression syndrome. Hemorrhagic rupture of a juxtafacet cyst and the resulting epidural hematoma may cause chronic and/or acute cauda equina compression. We report two cases of ruptured hemorrhagic lumbar synovial cysts resulting in epidural hematoma and progressive symptomatic cauda equina compression. Surgical excision of the epidural hematoma and the associated cyst resulted in complete resolution of symptoms. Rarely, juxtafacet cysts of the lumbar spine may rupture and hemorrhage into the epidural space causing symptomatic cauda equina compression. It is important to consider this entity when evaluating the patient with cauda equina compression. The findings of these cases give insight into the clinical presentation, operative treatment, and outcome in these patients.

Cauda Equina Compression After Trauma

A case report is presented. To describe a case of a spinal epidural lipoma presenting as a cauda equina compression syndrome secondary to trauma. Epidural lipomas are rare lesions that present as back pain with progressive neurologic symptoms. A patient presenting with cauda equina compression after an injury was investigated and treated surgically. The clinical follow-up period was 3 years. Imaging of the lumbar spine showed an extradural mass compressing the cauda equina. The patient underwent emergency surgery, and an adipose mass was removed. Neurologic recovery was observed and maintained 3 years after surgery. Previously asymptomatic epidural masses such as lipomas can present with neurologic deficit after trauma. Appropriate imaging can help in the diagnosis and management of such cases.

Acute bleeding into a filum terminale ependymoma

We present a case of a 63-year-old male patient who was admitted to our hospital due to an acute compression syndrome of the cauda equina. He had complained about a sciatica for at least one year. CT-diagnosis appeared to be negative, whereas a lumbar myelogram revealed a complete block at L2/3. Emergency surgery was performed, and an ependymoma of the filum terminale was removed into which it had bled massively. The case is compared to the literature findings. These relate ependymomas in the described region with acute onset more often to symptoms caused by subarachnoid bleeding. Mechanical and/or histopathological factors are discussed as the cause of acute bleeding. Spinal ependymomas represent a rare event compared to other neurosurgical diseases. Even more seldom are tumors of this kind causing an acute cauda equina compression syndrome.

FLEXION‐EXTENSION MYELOGRAPHY OF THE CANINE CAUDA EQUINA

The radiographic appearance of the canine dural end‐sac and its behavior during flexion and extension of the spine is described in a myelographic study in 22 normal dogs and 26 dogs with cauda equina compression syndrome. In more than 80% of the dogs, the dural sac ended at the level of the sacrum. There were relatively large individual differences in shape and size of the dural end‐sac. In contrast, shape, length, position, and diameter of the dural end‐sac at the level of the lumbosacral articulation is extremely constant during flexion and extension in normal individuals. In the 26 dogs with lesions affecting the cauda equina and nerve roots between L6 and the first caudal vertebra, myelography was diagnostic in 21 dogs. Myelographic diagnosis of cauda equina compression was possible in seven dogs with spine in flexion. In 14 dogs, overextension of the spine and imaging in lateral and dorsal recumbency was necessary to establish a diagnosis. The five dogs with nondiagnostic myelograms had either a dural end‐sac ending cranially to the lesion (two dogs), diseases not associated with compression (two dogs), or only slight indentations of the contrast medium column (one dog).

Cauda equina compression syndrome : Schnaid E., Eisenstein S. M. and Webb J. D. (1985) Delayed post traumatic cauda equina compression syndrome. J. Trauma25, 1099

Cauda equina compression syndrome : Schnaid E., Eisenstein S. M. and Webb J. D. (1985) Delayed post traumatic cauda equina compression syndrome. J. Trauma25, 1099

The narrow cervical spinal canal.

ABSTRACTAn element of developmental stenosis is present in a review of twelve patients presenting with cervical spondylotic myelopathy. Superimposed cervical spondylosis causes further canal narrowing to the extent that the minimal sagittal canal diameters of these patients measures from 5 mm to 10 mm.The maximal level of narrowing is at C3/C4 level where greatest stress is said to occur during neck movement.There is a possible association between cervical canal narrowing and lumbar canal stenosis (33% in this series).Advanced age of the patients and a moderately long history of CSM do not usually imply a poor prognosis.The control series show that cord compression signs are not present even with a sagittal diameter of 9 mm. This indicates that in CSM other factors are involved besides cervical canal stenosis.The most critical diameters are 6 mm and less. Under such circumstances surgery is indicated.Differentiation between CSM and a predominantly cauda equina compression syndrome does not generally pose a problem if attention is given to the importance of a very narrow cervical canal and the presence of an almost complete obstruction at cervical myelography.

ヒト黄色じん帯（ｌｉｇａｍｅｎｔｕｍ ｆｌａｖｕｍ）の生後発育と加齢的変化についての病理組織学的研究

Thickened or ossified ligamentum flavurn are taking interested in orthopedic surgeon srecently, because of much of these patients are liaiable to complain the spinal cord or cauda equina compression syndrome. The author performed to investigate the postnatal development and these changed ligamentum flavum with aging by light microscopically and electron micro-scopically.Besides histochemical localization in the ligamentum flavum was examined by means of Alkaline phosphatase, Acid phosphatase, and Adenosine triphosphatase as well as collagenase digestion and elastase digestion methods.Furthermore yellow pigment of the ligamentum flavum was identified with thin layer chromatography.Results: 1) In a newborn stage of the ligamentum flavum, specimens showed much collagenous fibrils, stained strongly positive by PAM, and sparse elastic fibers.2) The elastic fibers in a newborn stage appeared as an aggregation of PAM-positive microgranules mainly in PAM-negative collagenous matrix and in partly collagenous fibrils. It was clearly defined these microgranules in initial stages as PAM-positive amorphous material after elastase digestion. It was noticed that the PAM stain was most adequate method for staining these elastic fibers in a very initial stage, compared with other staining methods.3) The elastic fibers contained PAM-positive microfibrillar component in its interior, which was thought to be deformed collagenous fibrils in stages from newborn to adolescent. Wheas, that in a stage of adult or later did not contain those fillamentous material, but electron dense granular substance.4) In the matured elastic fibers, the author found clearly the microfibrillar layer in periphery of them. It was confirmed that the microfibrillar layers consisted of microfibrils as well as amorphous material, should be called “microfibrillar ground substance.”5) With double staining method after collagenase digestion, the author found the microfibrils clearly defined and the microfibrillar ground substance widened. With PAM stain after this digestion, PAM-positive materials disappeared in elastic fibers.6) With using double staining method after elastase digestion, vesiculation was observed in elastic fibers of an infantile stage. In elastic fibers in an adult stage, the enhancement of interior fillamentous or reticular materials was noticed, but the microfibrillar layers were not digested by elastase. The microgranules, stained strongly positive by PAM stain, remained unchanged in PAM stain after the digestion.7) Based on these data, it is presumably apparent that the elastase digests neither the elastic fibers completely nor microfibrillar layers, but does main elements partially. Opposed to asumption, it is realized that the collagenase does not give any significant alterations, but does the elastic fibers some changes to a certain extent, as far as objected by PAM stain.8) It was found that the yellow pigments of the ligamentum flavum may be equivalent to riboflavin and flavin mononucleotide (FMN).