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Intermittent parasympathetic symptoms in lumbar spinal stenosis.
J G Willén1, E R Griffiths, F L Mastaglia
1Department of Orthopaedics, Sahlgren Hospital, Göteborg, Sweden.
Journal of Spinal Disorders
|June 1, 1989
Summary
Autonomic nervous system symptoms like fecal incontinence and penile erections are rare in spinal stenosis. Surgical decompression via laminectomy effectively resolved these unusual symptoms in patients with lower lumbar spinal canal compromise.
Area of Science:
- Neurology
- Urology
- Gastroenterology
Background:
- Spinal stenosis, a condition causing narrowing of the spinal canal, can lead to neurological deficits.
- Autonomic nervous system dysfunction is an uncommon manifestation of spinal stenosis, particularly involving sacral nerve roots (S2-S5).
Observation:
- This report details two cases presenting with unusual autonomic symptoms during ambulation: one with fecal incontinence and another with intermittent penile erections.
- These symptoms are linked to compromise of the lower lumbar spinal canal, affecting sacral nerve roots.
Findings:
- Both patients experienced resolution of their respective autonomic symptoms following decompressive laminectomy.
- A review of prior literature identified six additional cases of parasympathetic disturbances attributed to lumbar spinal stenosis.
Implications:
- Decompressive laminectomy is an effective treatment for resolving rare autonomic dysfunction symptoms in lumbar spinal stenosis.
- Highlights the importance of considering spinal stenosis in the differential diagnosis for unexplained autonomic disturbances, especially those related to lower spinal cord compromise.