caa a22 4500 445833491 CHVBK 20180317145323.0 cr unu---uuuuu 170323e20110701xx s 000 0 eng 10.1007/s00586-010-1658-5 doi (NATIONALLICENCE)springer-10.1007/s00586-010-1658-5 Recurrent adjacent segment disease and cauda equina syndrome [Elektronische Daten] [Xavier Conesa, Ferran Pellisé, Susana Núñez, Carlos Villanueva, Enric Cáceres] Purpose: A case of cauda equina lesion as a result of recurrent adjacent segment degeneration (ASD) after multiple lumbar fusions is reported. ASD might be a consequence of biomechanical overload or simply a normal degenerative process. The reported clinical relevance of ASD is rather low. We describe an unusual case of cauda equina compression at L1-L2 in a patient who had undergone L2-L4 fusion 8years previously and 2 decompression-fusion surgeries 16years before. Materials and methods: A 72-year-old man, who had two previous lumbar fusion-decompression procedures, underwent a third lumbar surgery in December 2000 to treat symptomatic spinal canal stenosis associated with L3-L4 pseudoarthrosis. After a symptom-free period of 8years, the patient experienced low back pain radiating to both legs while standing, associated with saddle sensory disturbances and incontinence. Physical examination ruled out significant motor deficits. Plain radiographs showed solid fusion from L2 to L4, good spinal alignment, and low-grade L1-L2 retrolisthesis. Stainless steel pedicular instrumentation distorted magnetic resonance imaging, preventing adequate spinal canal evaluation. Electromyography demonstrated signs of cauda equina compression (bilateral L3-S2). CT myelography showed a stop at L1-L2, due to a severe spinal canal stenosis. L1-L2 decompression and fusion were performed. Results: After an uneventful surgery with no complications, the symptoms abated and incontinence recovered. Conclusions: Even if the reported clinical relevance of ASD is very low, fused patients with a constitutional narrow spinal canal are at risk of developing severe neural compression at the level adjacent to the fusion. Springer-Verlag, 2010 Recurrent disease nationallicence Adjacent segment nationallicence Cauda equina nationallicence Degenerative changes nationallicence Narrow spinal canal nationallicence Conesa Xavier Unitat d'estudi de la Patologia del Raquis, Hospital Universitari Vall d'Hebron, Pg/Vall d'Hebron 119-129, 08035, Barcelona, Spain aut Pellisé Ferran Unitat d'estudi de la Patologia del Raquis, Hospital Universitari Vall d'Hebron, Pg/Vall d'Hebron 119-129, 08035, Barcelona, Spain aut Núñez Susana Unitat d'estudi de la Patologia del Raquis, Hospital Universitari Vall d'Hebron, Pg/Vall d'Hebron 119-129, 08035, Barcelona, Spain aut Villanueva Carlos Unitat d'estudi de la Patologia del Raquis, Hospital Universitari Vall d'Hebron, Pg/Vall d'Hebron 119-129, 08035, Barcelona, Spain aut Cáceres Enric Unitat d'estudi de la Patologia del Raquis, Hospital Universitari Vall d'Hebron, Pg/Vall d'Hebron 119-129, 08035, Barcelona, Spain aut European Spine Journal Springer-Verlag 20(2011-07-01), 258-261 0940-6719 20<258 2011 20 586 https://doi.org/10.1007/s00586-010-1658-5 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00586-010-1658-5 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Conesa Xavier Unitat d'estudi de la Patologia del Raquis, Hospital Universitari Vall d'Hebron, Pg/Vall d'Hebron 119-129, 08035, Barcelona, Spain aut NATIONALLICENCE 700 1- Pellisé Ferran Unitat d'estudi de la Patologia del Raquis, Hospital Universitari Vall d'Hebron, Pg/Vall d'Hebron 119-129, 08035, Barcelona, Spain aut NATIONALLICENCE 700 1- Núñez Susana Unitat d'estudi de la Patologia del Raquis, Hospital Universitari Vall d'Hebron, Pg/Vall d'Hebron 119-129, 08035, Barcelona, Spain aut NATIONALLICENCE 700 1- Villanueva Carlos Unitat d'estudi de la Patologia del Raquis, Hospital Universitari Vall d'Hebron, Pg/Vall d'Hebron 119-129, 08035, Barcelona, Spain aut NATIONALLICENCE 700 1- Cáceres Enric Unitat d'estudi de la Patologia del Raquis, Hospital Universitari Vall d'Hebron, Pg/Vall d'Hebron 119-129, 08035, Barcelona, Spain aut NATIONALLICENCE 773 0- European Spine Journal Springer-Verlag 20(2011-07-01), 258-261 0940-6719 20<258 2011 20 586 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer