Cauda Equina Syndrome Caused by Lumbar Vertebral Fracture in an Elderly Patient with Ankylosing Spondylitis

Cauda Equina Syndrome in a Patient with Intradural Schwannoma at the Same Level as an Acute L2 Compression Fracture

“…CES is a mixture of neurologic symptoms and findings of different levels of severity, including lower extremity weakness, sensory loss, decreased reflexes, and, specifically, incontinence, usually associated with localized spinal stenosis with severe compression of the lumbar nerve roots often seen with larger intraspinal tumors [11-13]. Compression is commonly due to degenerative stenosis or spondylolisthesis, and, after spine trauma, fractures related to either posterior bone displacement or large extruded discs can also cause either neurogenic claudication and eventually CES [14-15]. Studies of both CT and MRI in relationship to CES have determined that it is uncommon to have symptomatic CES with less than 50% obstruction with spinal stenosis [12-13].…”

“…Each could have led to the development of CES separately. In patients with vertebral fractures, displaced endplates and, rarely, large herniated or extruded disc fragments can be associated with CES [15-16]. Severe canal compression with neurological sequelae is more commonly seen with high-velocity burst fractures than low-velocity osteoporotic fractures [16].…”

“…Dorsally migrated fragments have also been observed, however, actual neurologic deficits and especially CES is rare without a greater than 50% canal narrowing from the fracture even with kyphotic angulation [13-14]. Rarely, when there is a preexisting narrowed spinal canal from spinal stenosis or even ankylosing spondylitis with a superimposed fracture, CES can develop [15]. Progression of neurologic deficits with the delayed development of CES in burst fractures may indicate fracture expansion or fragment migration [16].…”

Depression, Pain, and Self-Efficacy in Fibromyalgia Syndrome

“…There is an interesting case report with a helpful literature review coming from Avcılar-_ Istanbul, Turkey (39). The case involves a cauda equina syndrome that developed in an elderly male with ankylosing spondylitis who developed spondylolisthesis at the L4-5 level following a low-energy fracture.…”