Rapid progression of acute sciatica to cauda equina syndrome.
OBJECTIVE: To demonstrate the importance of clinical examination and continued vigilance for neurologic deterioration in patients with sciatica. Cauda equina syndrome, a rare sequela of sciatica, is considered a medical emergency requiring surgical decompression. Clinical Features: A 32-year-old wom...
| Publicado en: | Journal of Manipulative & Physiological Therapeutics Vol. 24; no. 5; pp. 350 - 356 |
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| Autores principales: | , |
| Formato: | case study diagnostic images Journal Article |
| Publicado: |
Elsevier B.V.
Jun2001
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=107056273&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 107056273 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 01614754 8GE jtl: Journal of Manipulative & Physiological Therapeutics issn: 01614754 maglogo: N pubinfo: dt: Jun2001 vid: 24 iid: 5 pid: 1265 pub: Elsevier B.V. place: Philadelphia, Pennsylvania artinfo: ui: 107056273 107056273 2001091174 10.1067/mmt.2001.115261 NLM11416826 107056273 ppf: 350 ppct: 6 formats: fmt: @attributes: type: T tig: atl: Rapid progression of acute sciatica to cauda equina syndrome. aug: au: Busse JW Hsu WS affil: Clinical Sciences Resident, Dept of Graduate Studies, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada sug: subj: Sciatica Complications Polyradiculoneuritis Female Adult Polyradiculoneuritis Etiology Polyradiculoneuritis Physiopathology Polyradiculoneuritis Diagnosis Polyradiculoneuritis Epidemiology Polyradiculoneuritis Radiography Polyradiculoneuritis Therapy Chiropractic Assessment Adult: 19-44 years Female ab: OBJECTIVE: To demonstrate the importance of clinical examination and continued vigilance for neurologic deterioration in patients with sciatica. Cauda equina syndrome, a rare sequela of sciatica, is considered a medical emergency requiring surgical decompression. Clinical Features: A 32-year-old woman had sciatica that rapidly progressed to cauda equina syndrome. Magnetic resonance imaging revealed the presence of a large nonsequestered disk fragment in the lower lumbar spine. Intervention and Outcome: The disk fragment was surgically excised. The patient experienced immediate pain relief after surgery but retained neurologic deficits. After 6 months of rehabilitation, neurologic integrity was restored, aside from patchy sensory loss of the left foot and buttocks. At the 6-month follow-up, the patient's sciatica had not returned. CONCLUSIONS: Most cases of sciatica, regardless of cause, will self-resolve; as a result, there might be a tendency to maintain a low index of suspicion for serious, progressive disorders such as cauda equina syndrome. Patients need to be educated as to signs of this emergency condition and informed as to the possible consequences of delaying treatment. By maintaining a high index of suspicion for any case that fails to respond as expected to a course of conservative therapy or that demonstrates signs of cauda equina syndrome, chiropractors can assume a pivotal role by investigating and referring appropriately and by aiding in active rehabilitation postoperatively. pubtype: Academic Journal doctype: case study diagnostic images Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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