CAUDA EQUINA SYNDROME CAUSED BY LUMBAR DISC HERNIATION

Abstract

Cauda Equina syndrome is a clinic complication wich is characterized by the compression of the nerve roots. It has symptoms like strong backache, sciatica, saddle anesthesia, sexual and sphincter dysfunction and weakness in lower members. This report brings the pacient MRB, 35, male, teacher, who has backache as a clinical condition for 1 year. His physical examination presents painful facies, in the abdominal palpation, presents painful dilated bladder. In the neurologic exam, Lasegue + in left lower leg (LLL), Kernig + (LLL), saddle anesthesia, hypoesthesia of the posterior region (LLL), sole anesthesia, bilateral pattelar osteotendinous hyporeflexia, achilles reflex decreased. Into the magnetic resonance stands out a diffuse disc bulging, straightening the ventral face of the dural sac, standing out a posteromedian/paramedian extruded component in the left, on L5-S1 level, with a little caudal deviation and nerve root compression emerging from S1 into the left, and contact with the S1 into the right, and emerging from S2 into the left. The patient underwent surgery, with clinical improvement and was referred for the physiotherapy and outpatient follow-up. The commonest etiology of the cauda equina syndrome is herniated disc. Delayed diagnostic is the main cause of sequels, being the surgical intervention within 48 hours the most ideal alternative. Imaging is the gold standart for the diagnosis, and the clinic anamnesis too. The most influencing factors to the prognosis is the severity of sphincter disorder and the perianal hypoesthesia, thus, it´´´s avaliated in the admissional avaliation. This report is coherent with the literature findings.