Double Level Non-Contiguous Traumatic Lumbar Disc Herniation Presenting With Cauda Equina Syndrome: A Case Report and Literature Review

JBJS Case Connect. 2024 Apr 26;14(2). doi: 10.2106/JBJS.CC.23.00473. eCollection 2024 Apr 1.

Abstract

Case: A 52-year-old man presented with cauda equina syndrome after a motorcycle accident. Magnetic resonance imaging revealed traumatic disc herniation, at L2-L3 and L5-S1 levels without bony injury. He was managed successfully by wide laminectomy and microdiscectomy at both levels with complete neurological recovery at 2-month follow-up.

Conclusion: With a reported incidence of 0.4%, traumatic disc herniation in the lumbar region is an uncommon occurrence that may resemble a spinal epidural hematoma in acute trauma. Although MRI may not reliably differentiate spinal epidural hematoma from disc herniation, urgent surgical intervention may be required in profound neurological deficits.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Accidents, Traffic
  • Cauda Equina Syndrome* / diagnostic imaging
  • Cauda Equina Syndrome* / etiology
  • Cauda Equina Syndrome* / surgery
  • Diskectomy
  • Humans
  • Intervertebral Disc Displacement* / complications
  • Intervertebral Disc Displacement* / diagnostic imaging
  • Intervertebral Disc Displacement* / surgery
  • Laminectomy
  • Lumbar Vertebrae* / diagnostic imaging
  • Lumbar Vertebrae* / injuries
  • Lumbar Vertebrae* / surgery
  • Magnetic Resonance Imaging
  • Male
  • Middle Aged