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Partial cauda equina compromise: result of sacral stenosis.
Archives of Physical Medicine and Rehabilitation
|December 1, 1985
Summary
Sacral stenosis, a rare cause of cauda equina syndrome, can lead to severe neurological deficits. Surgical decompression of the sacrum effectively resolved symptoms in a patient with this unusual condition.
Area of Science:
- Neurology
- Neurosurgery
- Spinal Cord Medicine
Background:
- Cauda equina syndrome (CES) is typically associated with lumbar spinal stenosis.
- Sacral stenosis causing CES is exceptionally rare, presenting diagnostic and therapeutic challenges.
Observation:
- A patient presented with unilateral thigh/buttock pain, sensory deficits in the perineal region, urinary retention, and bowel dysfunction.
- Physical examination revealed diminished sensation, decreased anal sphincter tone, and an absent bulbocavernosus reflex.
- Lumbosacral imaging showed minimal degenerative changes, but myelography indicated significant extradural defects at L4-L5 and L5-S1.
Findings:
- Intraoperative findings revealed severe stenosis and thickening of the posterior sacrum compressing sacral nerve roots.
- A bilateral sacral laminectomy was performed to decompress the affected nerve roots.
Implications:
- This case highlights sacral stenosis as an unusual but treatable cause of cauda equina compromise.
- Prompt surgical intervention can lead to complete resolution of neurological deficits associated with sacral stenosis.