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The patient with lower back pain, sciatica, and inability to void

  • Gunnar B. J. Andersson
  • Thomas W. McNeill

Abstract

The constellation of signs and symptoms listed in Group D of Table 1 are known collectively as the “cauda equina syndrome”. The distinguishing feature of this syndrome is the involvement of the sacral roots below the S-1 level. These symptoms distinguish the cauda equina syndrome from acute benign lower back pain (Group A), acute lower back pain with radicular symptoms (Group C) and the lower back pain which is not primarily spinal in origin (Group B). In the early reports on disc operations this, most severe of the disc hernia syndromes, was represented by a disproportionate number of case. Seven of Mixter and Barr’s original cases had a variation of this syndrome. Large recent studies (Spangfort, 1972; Raaf, 1959) indicate that the actual incidence of cauda equina syndrome in patients with disc herniation is low; closer to two percent overall. It is important to recognize that disc herniation is not the only cause of cauda equina syndrome; but, it is by far the most common. Other causes of sacral root neural compression are tumors and infections.

Keywords

Lower Back Pain Urinary Retention Disc Hernia Surgical Decompression Acute Lower Back Pain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Aho AJ, Auranen A, Pesonen K (1969) Analysis of cauda equina symptoms in patients with lumbar disc prolapse. Acta Chir Scand 135: 413–420PubMedGoogle Scholar
  2. Floman Y, Wiesel SW, Rothman RH (1980) Cauda equina syndrome presenting as a herniated lumbar disc. Clin Orthop 147: 234–237PubMedGoogle Scholar
  3. Peyser E, Harari A (1977) Intradural rupture of lumbar intervertebral disk. Surg Neurol 8: 95–98PubMedGoogle Scholar
  4. Raaf J (1959) Some observations regarding 905 patients operated upon for protruded lumbar intervertebral disc. Am J Surg 97: 388–399PubMedCrossRefGoogle Scholar
  5. Shephard RH (1959) Diagnosis and prognosis of cauda equina syndrome produced by protrusion of lumbar disc. Br Med J 2: 1434–1439PubMedCrossRefGoogle Scholar
  6. Spangfort EV (1972) The lumbar disc herniation; a computer-aided analysis of 2,504 operations. Acta Orthop Scand [Suppl] 142: 1–95Google Scholar
  7. Tandon PN, Sankaran B (1967) Cauda equina syndrome due to lumbar disc prolapse. Ind J Orthop 1: 112–119Google Scholar
  8. Tay ECK, Chacha PB (1979) Midline prolapse of a lumbar intervertebral disc with compression of the cauda equina. J Bone Joint Surg [Br] 41: 43–46Google Scholar

Copyright information

© Springer-Verlag/Wien 1989

Authors and Affiliations

  • Gunnar B. J. Andersson
    • 1
  • Thomas W. McNeill
    • 1
  1. 1.Department of Orthopedic SurgeryRush-Presbyterian-St. Luke’s Medical HospitalChicagoUSA

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