Cauda Equina Syndrome in Lumbar Disc Disease

Abstract

A series of 42 patients with lumbar disc disease and herniation, presenting with the cauda equina syndrome, has been studied. It was observed that pure disc herniation accounted for the syndrome in five cases only. Associated structural lesions were contributory factors in the remaining 37 cases, and operative manipulation and trauma during disc removal through an interlaminar approach was the added factor in two of them. Wide laminectomy with excision of the overhanging facet joints and adequate visualization of the lumbar nerve roots has been found to be the ideal procedure for disc removal and for relief of the symptoms, including backache. No postoperative spinal instability has been observed. There was no mortality and the morbidity was insignificant. All cases have been followed up, and “good to excellent” results were obtained in 95 per cent of patients, and “fair” results in the other 5 per cent.

Key Words:

• cauda equina syndrome
• herniation
• limited approach for disc removal
• lumbar disc disease
• structural changes in the spine