A complication of spinal decompression. A case report.

Abstract

STUDY DESIGN: This case study is designed to report the previously unreported specific complication of acute cauda equina compression after decompression surgery for spinal stenosis. OBJECTIVES: To inform others of the possibility of such a complication; to suggest a possible mechanism for this situation, namely hourglass constriction of the cauda causing ischemia to distal nerve roots; and to suggest a management plan--immediate magnetic resonance imaging to identify the problem and return to the operating room for further decompression--which was successful in this case. SUMMARY OF BACKGROUND DATA: Previous reports of causes of paraparesis or paraplegia after surgery are listed, and previous theories on the etiology of acute cauda compression are discussed. METHODS: The clinical findings of spinal stenosis in a 32-year-old man are presented, and subsequent details of the surgery, complications after surgery, investigation, and future surgery, including magnetic resonance imaging scans before and after surgery, are provided. RESULTS: The result in this case was a patient free of symptoms. CONCLUSIONS: Incomplete decompression in surgery for spinal stenosis can result in acute cauda equina compression. In these circumstances, magnetic resonance imaging can reveal the cause, and in this case, immediate surgery was successful in relieving the symptoms and signs.