History :
A 31-year-old gentleman presented with a history of chronic low back pain, accompanied by right lower leg radiating pain, tingling, and numbness for the past 4 months. His symptoms significantly worsened over the past 5-6 days, leading to severe functional impairment, where he was unable to ambulate, sit comfortably, or perform basic activities such as using the restroom. This acute deterioration followed an episode of lifting heavy weights, which likely exacerbated his underlying condition.
Upon further evaluation, including imaging studies such as MRI, Spine Surgery Specialist in Pune Dr. Sangram Rajale identified lumbar canal stenosis as the underlying cause of cauda equina syndrome. Lumbar canal stenosis refers to the narrowing of the spinal canal in the lumbar region, which can occur due to degenerative changes, disc herniation, or other structural abnormalities, resulting in compression of the cauda equina nerve roots.
Despite initial reluctance and attempts at alternative therapies such as ayurveda, the patient’s symptoms persisted, prompting him to opt for surgical intervention.
ON EXAMINATION OF LUMBAR SPINE:
Clinical examination revealed early signs of cauda equina syndrome, including perineal numbness. This condition, identified by Best Orthopedic Spine Doctor in Pune Dr. Sangram Rajale, is a serious neurological issue caused by compression of the nerve roots of the cauda equina. The compression leads to sensory, motor, and autonomic deficits, often manifesting as lower back pain, radicular pain, and bladder or bowel dysfunction. Sensation was reduced on the right L5-S1 dermatome.
MRI :
- Diffuse Circumferential Disc Bulge at the L4-L5 level, indicating pressure on the spinal cord and nerve roots.
- Postero-Central Disc Protrusion suggesting disc herniation compressing the spinal cord or nerves.
- Ligamentum Flavum Thickening contributing to spinal canal narrowing.
These findings indicated severe nerve compression, which are characteristic of cauda equina syndrome.
Operation :
On July 1, 2022, the patient underwent an L4-L5 laminectomy with discectomy under general anesthesia. The surgery was performed by Best Spine Specialist in Pune Dr. Sangram Rajale to address cauda equina syndrome. The procedure involved removing part of the vertebral bone (lamina) and the damaged intervertebral disc to decompress the spinal canal and relieve nerve compression.
Condition On Discharge :
- The patient remained stable throughout the postoperative period.
b. He experienced complete relief from pain in his leg and lower back, showing successful resolution of the nerve compression.
c. Walking exercises were initiated on the second day post-surgery, leading to early mobilization.
d. By the third day, he was climbing stairs, demonstrating improved mobility.
e. By the tenth day, he showed recovery in his bladder complaints, indicating resolution of urinary symptoms.
f. He did not experience any signs of infection, such as fever or chills, post-surgery, reflecting a smooth recovery after being treated by Top Spine Specialist in Pune Dr. Sangram Rajale.
FAQ's :
Lumbar radicular pain.
It is a type of pain that originates from the nerve roots in the lower back and radiates to the buttock, leg, or foot.
Lumbar radicular pain is caused by compression, irritation, or inflammation of the nerve roots, often due to a herniated disc, spinal stenosis, spondylolisthesis, bone spurs, infection, tumor, or trauma.
The main symptom of lumbar radicular pain is a sharp, shooting, or burning pain that travels from the lower back to the buttock, leg, or foot, usually on one side of the body. The pain may be worse with certain movements, such as bending, twisting, or coughing. Other symptoms may include numbness, tingling, weakness, or loss of reflexes in the affected area.
To diagnose lumbar radicular pain, a physical examination and some tests, such as X-rays, MRI, or CT scan are done, to identify the source of the nerve compression. Treatment may include conservative methods, such as medication, physical therapy, or injections, or surgery, if the pain is severe or does not improve with conservative treatment.