Why the study?
Cauda equina syndrome is a devastating complication requiring urgent decompression, and extreme spinal manipulation during total hip replacement under neuraxial blockade represents a rare potential cause.
Highlights a rare cause of cauda equina syndrome due to extreme spinal manipulation during total hip replacement under neuraxial blockade, emphasizing the need for early diagnosis and decompressive surgery.
Extreme spinal manipulation may precipitate CES; this case leaves open questions on procedural risk mitigation.
Cauda equina syndrome (CES) is a rare but devastating complication, which warrants an urgent or emergency decompressive surgery. To diagnose it early and also, a timely intervention can halt neurological sequelae. More common causes for CES include chronic disc diseases, spinal injury, and fractures. However, there are less common causes such as spinal manipulation, tuberculosis, and spinal tumors. Here, we report a rare cause of CES precipitated by extreme manipulation of the spine during total hip replacement surgery done under neuraxial blockade. This condition was diagnosed by the acute pain service team at an early stage and successfully treated with emergency decompressive surgery to avert any further neurological complications.
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Mujahid et al. (2020) studied this question.
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