217. Adult Male with Atraumatic Lower Back Pain and Leg Weakness

  1. Christopher P. Holstege MD1,2,3,
  2. Alexander B. Baer MD1,4,
  3. Jesse M. Pines MD, MBA, MSCE5,6 and
  4. William J. Brady MD7,8,9

Published Online: 3 AUG 2011

DOI: 10.1002/9781444397994.ch217

Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition

Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition

How to Cite

Holstege, C. P., Baer, A. B., Pines, J. M. and Brady, W. J. (eds) (2011) Adult Male with Atraumatic Lower Back Pain and Leg Weakness, in Visual Diagnosis in Emergency and Critical Care Medicine, Second Edition, Wiley-Blackwell, Oxford, UK. doi: 10.1002/9781444397994.ch217

Editor Information

  1. 1

    Division of Medical Toxicology, University of Virginia School of Medicine, Charlottesville, VA, USA

  2. 2

    Blue Ridge Poison Center, University of Virginia School of Medicine, Charlottesville, VA, USA

  3. 3

    Departments of Emergency Medicine & Pediatrics, University of Virginia School of Medicine, Charlottesville, VA, USA

  4. 4

    Department of Emergency Medicine, University of Virginia School of Medicine, Charlottesville, VA, USA

  5. 5

    Center for Health Care Quality, George Washington University, Washington, DC, USA

  6. 6

    Departments of Emergency Medicine and Health Policy, George Washington University, Washington, DC, USA

  7. 7

    Department of Emergency Medicine, University of Virginia, Charlottesville, VA, USA

  8. 8

    Center for Emergency Management, University of Virginia Health System, Charlottesville, VA, USA

  9. 9

    Charlottesville-Albemarle Rescue Squad & Albemarle County, Fire Rescue, Charlottesville, VA, USA

Publication History

  1. Published Online: 3 AUG 2011
  2. Published Print: 12 AUG 2011

ISBN Information

Print ISBN: 9781444333473

Online ISBN: 9781444397994

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Keywords:

  • Case 107, adult male with atraumatic lower back pain - and leg weakness;
  • diagnosis - Cauda equina syndrome;
  • Cauda equina syndrome (CES), a neurologic disorder - compression of spinal nerve roots;
  • CES, with lower extremity weakness - perineal numbness and bladder and/or bowel dysfunction;
  • typical patient, adult male in fourth and fifth decade - disc herniation, and lower back discomfort;
  • neurologic deficits, bilateral leg weakness - positive straight leg raise, decreased deep tendon reflexes, saddle anesthesia;
  • suspicion for diagnosis, awareness of syndrome - coupled with clinical suspicion for CES;
  • patients, with suspected CES - undergoing MRI of spine, for lesion confirmation;
  • early surgical intervention, best approach - within first 48 hours, after diagnosis;
  • patients in earlier operations, with decreased neurologic disability - left with permanent deficits