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Cauda equina syndrome with normal lumbar myelography
1Department of Orthopedics, St Göran's Hospital, Stockholm, Sweden.
Acta Orthopaedica Scandinavica
|June 1, 1989
Summary
Patients with cauda equina syndrome and normal lumbar myelography have a favorable prognosis. Further investigation, like thoracic spine imaging, is only recommended if severe symptoms persist despite normal computed tomography scans.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Cauda equina syndrome presents with emergency symptoms.
- Lumbar myelography is a key diagnostic tool.
- Interpreting normal findings in suspected cauda equina syndrome requires careful consideration.
Purpose of the Study:
- To evaluate the outcomes of patients presenting with emergency signs of cauda equina compression.
- To assess the significance of a normal lumbar myelography in these patients.
- To determine appropriate management strategies for suspected cauda equina syndrome with normal initial imaging.
Main Methods:
- Retrospective analysis of 19 patients with signs of cauda equina compression.
- Review of lumbar myelography results.
- Follow-up assessment of patient recovery and further investigations.
Main Results:
- 13 out of 19 patients experienced spontaneous recovery.
- Two patients were diagnosed with thoracic spine pathologies (tumor, herniated disc) on further imaging.
- Other causes identified included functional paresis and non-spinal conditions.
Conclusions:
- A normal lumbar myelography in suspected cauda equina syndrome indicates a favorable prognosis.
- Surgical intervention is generally not indicated in such cases.
- Thoracic spine myelography should be considered for persistent, severe symptoms when CT scans are normal.