Microsurgical reconstruction of the cauda equina after traumatic transecting injury

Abstract

All four patients presented complete distal sensory and motor palsy affecting the lower lumbosacral roots. Primary microsuture was feasible in three patients harboring stab wounds, whereas autologous nerve graft interposition was necessary in the patient who had a gunshot wound. At the 5-year follow-up, we observed a marked improvement in motor function in two patients, but no sensory recovery.

Penetrating Iron Rod Wound of the Lumbar Spine Causing Cauda Equina Syndrome in a Child: Case Report and Review of the Literature

“…3 CES is a complex neurological disorder with a myriad of symptoms such as low back pain, unilateral or bilateral leg pain, paresthesias and weakness, perineal anesthesia, sphincter incontinence, and other less common symptoms. 4 Traumatic cauda equina injuries most commonly cause sudden and acute neurological deterioration. During the initial emergency evaluation, care should be taken to recognize lower extremity sensitive and motor deficits.…”

“…1 CT and magnetic resonance imaging (MRI), as well as an electrophysiological workup, allow an accurate diagnosis in the acute phase. 4 However, due to the low availability and high cost of MRI and electrophysiological assessment in our socioeconomic context, the lesion assessment of our patient was established on X-ray and CT scan, which were sufficient for surgical planning. A precise clinical examination and a thorough analysis of the preoperative imaging are mandatory to define upstream the objectives of the surgery.…”