title: Microsurgical reconstruction of the cauda equina after traumatic transecting injury.
abstract: BACKGROUND
  The microsurgical reconstruction of the cauda equina nerve roots (MRCER) after traumatic injury is a highly controversial procedure with very few reports in the literature.
  
  
  METHODS
  We report on four patients who had a penetrating traumatic injury in the lumbosacral area and underwent primary MRCER at our institution during the last decade.
  
  
  RESULTS
  All four patients presented complete distal sensory and motor palsy affecting the lower lumbosacral roots. Primary microsuture was feasible in three patients harboring stab wounds, whereas autologous nerve graft interposition was necessary in the patient who had a gunshot wound. At the 5-year follow-up, we observed a marked improvement in motor function in two patients, but no sensory recovery.
authors.affiliation: Department of Neurology, Medical School, Universidade de São Paulo, São Paulo, Brazil, dr.antonioaraujojr@gmail.com.
authors.forename: Antonio
authors.initials: A
authors.lastname: Tedesco-Marchese
authors.forename: Manoel Jacobsen
authors.initials: MJ
authors.lastname: Teixeira
authors.forename: Antonio Santos
authors.initials: AS
authors.lastname: de Araújo
authors.forename: Mirella Martins
authors.initials: MM
authors.lastname: Fazzito
authors.forename: Guilherme
authors.initials: G
authors.lastname: Lepski
mesh_terms: D000328:Adult; D000714:Anastomosis, Surgical; D002420:Cauda Equina / Q000293:injuries* / Q000601:surgery*; D005260:Female; D006801:Humans; D007796:Laminectomy; D008161:Lumbosacral Region / Q000601:surgery; D008297:Male; D008866:Microsurgery / Q000379:methods*; D010243:Paralysis / Q000209:etiology; D011128:Polyradiculopathy / Q000209:etiology / Q000601:surgery*; D019651:Plastic Surgery Procedures / Q000379:methods*; D020127:Recovery of Function; D016896:Treatment Outcome; D014948:Wounds, Gunshot / Q000601:surgery; D014951:Wounds, Stab / Q000601:surgery; D055815:Young Adult