Postoperative Cauda Equina Syndrome in Trivial Lumbar Congenital Kyphosis: A Case Report

  • Farzad Omidi-Kashani Mail Department of Orthopedic, Orthopedic Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Ebrahim Ghayem Hasankhani Department of Orthopedic, Orthopedic Research Center, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
Keywords:
Congenital kyphosis, Cauda equina syndrome, Disc herniation, Neurologic deficit

Abstract

A 25-year old man presented with chronic low back pain for about 5 years due to mild congenital lumbar kyphosis (L1-L3 25° with congenital posterior wedge vertebra L2). Preoperative neurologic examination was normal. After posterior spinal fusion and instrumentation with moderate curve correction, the patient gradually developed the symptoms and signs of cauda equina syndrome due to intraoperative L2-3 disc herniation. After 5 days the patient underwent posterior decompression surgery and on the latest follow up visit at 2 years later, nearly all the motor power was recovered but the patient complained of occasional urinary incontinence and residual right leg paresthesia. In surgical treatment of congenital kyphosis, much attention should be paid to the presence of contemporaneous asymptomatic disc herniation.

References

Lonstein JE, Winter RB, Moe JH, Bradford DS, Chou SN, Pinto WC. Neurologic deficits secondary to spinal deformity. A review of the literature and report of 43 cases. Spine 1980 (4):331-55.

Van Gorp V, Dricot F, van Berlaer G, Van Rompaey K, Hachimi-Idrissi S. Congenital cervical kyphosis in a child associated with tetraparesis: case report. Pediatr Neurosurg2009;45(6):422-4.

Jung SH, Bang MS. A case of congenital kyphosis misdiagnosed as cerebral palsy. Childs Nerv Syst 2007;23(10):1205-8.

Nomura H, Terada K, Kobara N, Miyazaki K, Yuasa M, Murata D, Miyahara H. Surgical treatment of congenital kyphosis associated with progressive spastic paralysis in an adult patient. Neurol Med Chir (Tokyo) 2006;46(6):313-7.

Sato T, Kokubun S, Tanaka Y, Aizawa T. Paraparesis associated with mild congenital kyphoscoliosis in an adult. Tohoku J Exp Med 1997;183(4):303-8.

Winter RB, Moe JH, Wang JF. Congenital kyphosis. Its natural history and treatment as observed in a study of one hundred and thirty patients. J Bone Joint Surg Am 1973;55(2):223-56.

McMaster MJ, Singh H. Natural history of congenitalkyphosis and kyphoscoliosis. A study of one hundred and twelve patients. J Bone Joint Surg Am 1999;81(10):1367-83.

Llado RJ, Hwang S, Cuddihy L, Cahill P, Samdani A. Intraoperative disc herniation during posterior spinal fusion for correction of Scheuermann’s Kyphosis. 2011;36(9):E615-7.

Coe JD, Smith JS, Berven S, Arlet V, Donaldson W, Hanson D, Mudiyam R, Perra J, Owen J, Marks MC, Shaffrey CI. Complications of spinal fusion for Scheuermann kyphosis: a report of the scoliosis research society morbidity and mortality committee 2010; 35(1):99-103.

McEwen GD, Bunnell WP, Sriram K. Acute neurologic complications in the treatment of scoliosis. A report of the Scoliosis Research Society. J Bone Joint Surg Am 1972;57(3):404–8.

How to Cite
1.
Omidi-Kashani F, Ghayem Hasankhani E. Postoperative Cauda Equina Syndrome in Trivial Lumbar Congenital Kyphosis: A Case Report. Acta Med Iran. 51(11):811-813.
QRcode
Section
Articles