A 64-year-old man was referred to A&E by his general practitioner with worsening back and acute bilateral leg pain and weakness with urinary retention. His MRI scan demonstrated spinal canal stenosis at the level of L1–L2 and a diagnosis of cauda equina syndrome (CES) was made. CES is a rare neurological condition caused by compression of the central spinal nerves at the termination of the cord. CES is a surgical emergency requiring urgent assessment and treatment. The patient underwent urgent surgical decompression; however, he required a second surgery for further decompression as repeat MRI showed persistent stenosis with further extension. Intraoperative Doppler ultrasonography revealed an intradural lesion, which was surgically excised and found to be a sequestrated lumbar disc in the intrathecal space. The patient showed significant neurological improvement post revision decompression.
- orthopaedic and trauma surgery
- spinal cord
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Contributors All authors contributed to the production of the manuscript in a significant way.
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.
Provenance and peer review Not commissioned; externally peer-reviewed.
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