Index to Chiropractic Literature
Index to Chiropractic Literature
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ID 15735
  Title Atypical presentation of cauda equina syndrome [CES][case report]
URL http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2505103/
Journal J Can Chiropr Assoc. 2002 Mar;46(1):31-38
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Peer Review Yes
Publication Type Case Report
Abstract/Notes Cauda equina syndrome (CES) has been described in the literature as a clinical entity consisting of low back pain, bilateral leg pain with motor and sensory deficits, genitourinary dysfunction with overflow incontinence or retention, and faecal incontinence. CES has been recognised as a rare complication of spinal manipulative therapy, and is an absolute contraindication to this type of therapy. A case of CES that presented in an atypical manner is presented, highlighting the lack of leg symptomatology, but with the presence of painless urinary retention. A definition of CES as a condition presenting with bladder dysfunction and possible motor and/or sensory loss in the region of sacral and/or lumbar dermatomes is discussed. Evaluation of patients with lumbar disc pathology who are suspected of suffering from CES should include questioning regarding urinary difficulty and neurologic examination of the sacral plexus, including sensation; and may include advanced imaging such as contrast computerized tomography (CT) scan or magnetic resonance imaging (MRI). Immediate referral for consideration of decompression surgery is recommended for optimal recovery of neurologic function. Clinicians should be knowledgeable of the various forms CES can present in, and maintain a high index of suspicion for this condition in patients with suspected lumbar disc herniation or urinary dysfunction.This abstract is reproduced with the permission of the publisher. Click on the above link for free full text.
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