Published in:
01-09-2008 | Orthopaedic Surgery
Two-stage decompression for combined epiconus and cauda equina syndrome due to multilevel spinal canal stenosis of the thoracolumbar spine: a case report
Published in: Archives of Orthopaedic and Trauma Surgery | Issue 9/2008
Login to get accessAbstract
Introduction
A case of combined epiconus and cauda equina syndrome due to multilevel spinal canal stenosis of the thoracolumbar spine is reported.
Methods
A 76-year-old man with multilevel spinal canal stenosis of the thoracolumbar spine (Th11–12, L2–S) who showed symptoms of epiconus syndrome was reported. First, we performed anterior decompression and fusion at the thoracolumbar junction (decompression: Th11–12, fusion: Th10–L2), which ameliorated his symptom partially. However, he presented cauda equina symptoms. Then, he underwent posterior spinal decompression (L3–5) and fusion (Th12–L5).
Results
After anterior decompression, several symptoms disappeared. However, motor and sensory disturbance below L4 and bladder–bowel disturbance remained. We then performed a secondary operation. At three years’ follow-up, he was able to walk with the aid of a cane.
Conclusions
Combined epiconus and cauda equina syndrome due to multilevel spinal canal stenosis was treated by combined two-stage anterior and posterior decompression. In this case, multilevel decompression via anterior and posterior approaches was necessary to relieve the symptoms.