Neurinomas of the cauda equina clinical analysis of 40 surgical cases

We report a retrospective study conducted on 40 patients with neurinoma of the cauda equina, assessing the clinical features and treatment. Neurinomas are clinically indistinguishable from other tumours localized in the same region. It is possible, but not simple, to differentiate neurinoma of the cauda equina from more common lumbar disc herniations. In the early stage, neurinomas provoke sciatic pain that is unilateral and monoradicular, worsened in decubitus and hard to define, whereas in the later stage pain becomes bilateral, polyradicular and is mostly accompanied by motor and sensory disturbances. Moreover, Lasegue's sign was often absent. Therapeutically, total removal of the tumour seems to be the most appropriate form of treatment given that even the sacrifice of a root does not worsen any pre-existing neurological deficit.