Tagged: Cauda Equina Syndrome
-
AuthorPosts
-
I have read on your website of the symptoms of Cauda Equina. My question is if early on, the symptoms can come and go?
I have loss of complete sensation in the saddle area. I often find that I can suddenly need to pass urine and even have an accident because I can’t get there quickly enough. I have even found that I have had an accident that I was unaware of. Occassionally I have suffered with bowel leakage.
On getting up from sitting, I often find it very difficult to walk because my right leg gives way. This only lasts for the first 6 – 10 steps and then it is ok to walk on.I do have the two levels above my lumbar fusion at L4/5 that are now herniated and causing nerve compression and sciatic type pain, sometimes on the top of my thigh though.
Also the two levels below my ACDF of C3/4/5 have now gone and are practically bone on bone.
I also have 3 thoracic discs that are compressing my spinal cord.
The whole of my spine is very degenerated and all the discs are exteremely thing and the osteophytes have changed the shape of my vertebrae. I have lost the curve in my neck.I would really value your opinion of this Dr Corenman.
You have some symptoms of cauda equina syndrome but this syndrome is very rare and normally comes on very quickly due to a large disc hernation. The physical examination would be exceedingly important. Long tract signs would indicate an upper motor neuron cause which would rule out cauda equina syndrome. There is typically loss of reflexes and significant weakness associated with cauda equina syndrome. The herniation in the lumbar spine would have to fill almost the entire canal to compress Nervi Erigantes (the bowel and bladder nerves). There are other disorders that can mimic some of the symptoms of cauda equina syndrome.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.Thank you for your reply Dr Corenman.
I am pleased to say that I had an urgent full spine MRI scan yesterday and will be seeing a neurosurgeon on Monday.Let the forum know the follow-up please.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.I assume that there was nothing worrying on the scan.
The neurosurgeon that I saw was very vague. He didn’t do any neurological examination at all.
He didsn’t talk about my symptoms although I did ask about bowel and bladder problems and if I was correct that they would come on very quickly and be extreme, he said yes they would, so I assume it is not Cauda Equina.He did look at the scan of my neck, thoracic and lumbar spine.
He said that my neck doesn’t need anything done because there is still just enough room for the spinal fluid to flow around my cord. He didn’t comment on this appointment on the discs below the fused levels, where they are practically gone and the vertebrae almost bone on bone and with lots of osteophyes changing the shape of the vertebrae.He looked at my thoracic scan and pointed out some herniated discs that are compressing my subarachnoid level of my cord. He talked about doing surgery on the two worst levels at T7/8 and T9/10 and said he would have to deflate my lung and remove a rib to access them.
He then looked at my lumbar scan and pointed out how the two levels above my fusion of L4/5 have now herniated and that the facet joints are hypertrophied and pressing into the spinal canal meaning there is little room there. He said that if he did surgery there he would have to fuse both these levels and extend the existing fusion which would be very invasive. He didn’t explain why this would be very invasive.
Could you please explain this to me Dr Corenman.He then said that he was reluctant to do another surgery on my spine because I have so much degeneration throughout all levels. He said it was highly likely to cause other levels to also go and cause a domino effect throughout my spine.
All in all, the appointment was very disappointing and not helpful.
The follow up letter to my GP didn’t represent what he had described on the scans. His letter said that I have ‘some mild disc degeneration’ in my neck.
He said that in my thoracic spine, ‘as previously, there are 2 small left sided lateral throacic disc prolapses not compressing the spinal cord which could account for some radicular pain.’
He then said that ‘at the L3/4 level which is the level above the site of her previous fusion there has been some degeneration with some facet joint hypertrophy.’ This could account for some of her back pain.
He also said that I have ‘widespread spondylolisthesis affecting her neck, lumbar spine and thoracic spine.’ I am sure that this is an error made by his secretary and that he actually means spondylosis.
I feel very let down and wonder why on earth he ever mentioned surgery if things were as he described in his letter to my GP.
This surgeon has had a case in the high court against him by a patient who had thoracic spine surgery by him and is now in a wheelchair. The patient has won the case on the grounds that the posterior access that this surgeon took is outdated now because of the danger to the spinal cord. The General Medical Council however, haven’t taken action so they must not feel he had done anything wrong. I wonder if he doesn’t want to be my surgeon because of my problems in the thoracic level of my spine and was just trying to put me off when he described the surgery on my thoracic discs. If that is the case, I wish he would just refer me to someone else. I feel very confused about all this.
Boy, your surgeon’s report is confusing. He or she also did not convey the same information to your GP. Maybe you can ask the office staff to refer you to someone who is better at explaining what causes your symptoms and what could be considered to help you.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books. -
AuthorPosts
- You must be logged in to reply to this topic.