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CASE REPORT
Non-compressive postoperative cauda equina syndrome following decompression and transforaminal interbody fusion surgery
  1. Mantu Jain1,
  2. Sudhanshu Sekhar Das1,
  3. Sudarsan Behera1 and
  4. Amit Tirpude2
  1. 1 Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
  2. 2 Anatomy, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
  1. Correspondence to Dr Mantu Jain, montu_jn{at}yahoo.com

Abstract

Postoperative cauda equina syndrome (CES) is a known rare complication following lumbar disc surgery. Seldom are they seen following decompression for spinal stenosis and may be actually more frequent and under-reported? Emergent surgical exploration remains the mainstay of management as the factors responsible for postop CES remains a variety of compressive forces. Yet many a time postoperative imaging or surgical exploration fails to identify a pathology and this leads to an ischaemic theory responsible for CES. Our article highlights conservative management in these selective group. We share our experience in two cases of incomplete CES during our routine transforaminal interbody fusion which we followed closely without re-exploration eventually ending in a favourable outcome. Key messages: The factors responsible for postop CES remains mostly a variety of compressive forces though in some instances postoperative imaging or surgical exploration fails to identify such in some cases. This leads to an ischaemic theory responsible for CES. The role of conservative management of postoperative CES in certain selective cases has a favourable outcome as illustrated in our cases.

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Footnotes

  • Contributors MJ operated the case with SSD in case 1 and SB in case 2. Both patients were investigated by MJ, SSD and SB. AT was responsible for follow-up. AT and SB wrote the paper, and MJ and SSD searched the literature and gave intellectual inputs. All authors have read and agree to the contents of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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