CAUDA EQÜINA SYNDROME SECONDARY TO LUMBAR DISC HERNIATION. REPORT OF CASE

Abstract

Introduction: The cauda equina syndrome can be traumatic and non-traumatic. The lumbar disc herniation, although rare, has been associated with the cauda equina syndrome of traumatic origin. Its incidence is 1% to 2% of cases of disc herniation, mainly located between L4-L5. It has been considered a neurosurgical emergency. Early surgical treatment has been indicated and in cases of incomplete injury produces satisfactory results in most cases. Case report: JMS, female, 56 years old, home. Four months ago started with a backache and moderate intensity radiated to the left lower limb. The pain was getting worse progressively in the last two months and did not give more to the use of simple analgesics. Neurological examination: difficulty in walking free, saddle hypoesthesia, hyporeflexia osteotendinosa bilateral patellar and ankle disorders and sphincter. MRI of the lumbosacral spine: lumbar disc herniation showed voluminous located between L4-L5. Results: Due associated systemic diseases (diabetes, hypertension and nephropathy secondary to hypertension), surgery was contraindicated, being held in outpatient treatment with rest and physical therapy. Conclusion: The cauda equina syndrome is associated with lumbar disc herniation bulky. Early surgery, when performed within 24/48 hours of onset of symptoms, has shown good results, despite the existing controversies in the medical literature about the appropriate time for intervention. In our case due to the progression of the neurological and systemic diseases associated with being contraindicated by clinical general surgery / anesthesiology and underwent conservative treatment with moderate improvement of neurological symptoms.