Non-traumatic cauda equina syndrome in adults. What etiology? About 76 cases

Abstract

Cauda equina syndrome is a rare neurological disease caused by compression of the cauda equina. The ponytail consists of the spinal nerves L2-L5, S1-S5 and the coccygeal nerve. We carried out a retrospective study over a period of two years (24 months), ranging from January 01, 2020, to December 31, 2021, from the files of patients referred for lumbosacral magnetic resonance imaging (MRI) or CT scan exploration in the context of low back pain or sciatica resistant to disabling medical treatment, a neurological deficit of the lower limbs associated or not with the bladder and/or rectal sphincter disorders, without any notion of trauma, with as judgment criterion the demonstration of an anomaly responsible for compression of the roots of the ponytail. We collected seventy-six (76) patients, with an average age of 53.5 years old and at extremes ages of 15 years and 89 years. We noted a female predominance with a sex ratio of 1.5 in favour of the female sex. Most of the patients were explored with MRI in 89 % of cases. Our patient history was dominated by cancer pathologies, with breast cancer in 24% of cases and prostatic cancer in 18% of cases. Sphincteric disorders mainly represented the symptomatology presented by the patients in 47% of cases and lumboscialitica in 28% of cases. The conflicting disc herniation dominated the etiologies in 36 % of cases, followed by secondary vertebral neoplastic lesions in 20% of cases. MRI and CT scans are important radiological modalities in characterizing lesions responsible for cauda equina syndrome in adults. The CT scan is effective in the study of bone and the MRI in the study of nerve roots, intervertebral discs and paravertebral soft tissues