title: Neurological Recovery in Two Patients with Cauda Equina Syndrome Secondary to L5 Lumbar Spine Giant Cell Tumour after Treatment with Denosumab without Surgery.
abstract: We report two patients with cauda equina syndrome (CES) secondary to L5 giant cell tumour (GCT) who achieved good neurological recovery after treatment with denosumab without surgery. The first patient was a 26-year-old man with L5 GCT causing CES who regained bowel and urinary control, muscle power improvement from grade 2 to grade 4 and Oswestry disability index (ODI) improvement from 48 to 23 after denosumab treatment. The second patient was a 25-year-old woman with L5 GCT causing CES who regained bowel and urinary control, muscle power improvement from grade 0 to grade 4 and ODI improvement from 42 to 20 after denosumab treatment. The usage of denosumab in the treatment of patients with CES due to GCT allows potential neurological recovery without any surgical intervention. If surgery is not contraindicated, more time is obtained to prepare the patient preoperatively to attain safer surgery and to achieve complete tumour clearance.
authors: Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia.
authors: Simret Singh
authors: SS
authors: Randhawa
authors: Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia.
authors: Angel Khor Nee
authors: AK
authors: Kwan
authors: Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia.
authors: Chee Kidd
authors: CK
authors: Chiu
authors: Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia.
authors: Chris Yin Wei
authors: CY
authors: Chan
authors: Department of Orthopaedic Surgery, National Orthopaedic Centre of Excellence for Research and Learning, University of Malaya, Kuala Lumpur, Malaysia.
authors: Mun Keong
authors: MK
authors: Kwan
keywords: Cauda equina syndrome; Denosumab; Giant cell tumour; Oncology; Spine