Lumbar Disc Herniation with Cauda Equina Syndrome after Self Traction Therapy: A Case Report.
- Author:
Yong Min KIM
1
;
Choong Hee WON
;
Joong Bae SEO
;
Eui Seong CHOI
;
Ho Seung LEE
;
Sang Wook KO
;
Eung Rok KIM
Author Information
1. Department of Orthopaedic Surgery, College of Medicine, Chungbuk National University, Cheongju, Korea. ymkim@med.chungbuk.ac.kr
- Publication Type:Case Report
- Keywords:
Traction therapy;
Lumbar disc herniation;
Cauda equina syndrome
- MeSH:
Adult;
Attention;
Cauda Equina*;
Emergencies;
Exercise Therapy;
Follow-Up Studies;
Foot;
Humans;
Intervertebral Disc Displacement;
Laminectomy;
Low Back Pain;
Magnetic Resonance Imaging;
Natural History;
Neurologic Manifestations;
Paresthesia;
Polyradiculopathy*;
Retrospective Studies;
Spine;
Traction*
- From:Journal of Korean Society of Spine Surgery
1999;6(3):469-474
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
STUDY DESIGN: A retrospective case report of lumbar disc herniation with cauda equina syndrome after self traction therapy. OBJECTIVES: Documentation of clinical significance and manifestations of disc herniation with cauda equina syndrome as one of the complications after self traction therapy. SUMMARY OF BACKGROUND DATA: Various conservative managements of acute low back pain in adults such as traction, spine manipulation therapy(SMT), and exercise therapy may produce harmful complications, especially when performed by non-professional therapists. Recently, reports of complication from SMT are increasing, however, understanding of biomechanism and natural history of traction, SMT, and exercise therapy are still poor. Therefore background information on the possible complications from their management is essential for physicians. METHOD: A case of acute cauda equina syndrome after self traction therapy in a 41 year-old man. Magnetic resonance imaging revealed severe compression of cauda equina by a huge mass. Emergency lumbar laminectomy was performed and all the compressing mass was removed. The mass was proven to be prolapsed disc of nearly whole nucleus amount and scanty nucleus was found within the disc space. RESULT: Acute low back pain and radiating pain disappeared immediately after operation. And neurologic deficits began to improve after postoperative 1 week. At the 15 month follow-up, the patient had recovered fully except minimal paresthesia on the right foot. CONCLUSION: More attentions to the possibility and clinical features of this complication seemed to be needed to the clinicians and therapists who do conservative management for the low back problems, especially SMT, traction, exercise therapy etc.
