title: Cauda equina syndrome. An emergency, some unexpected severe symptoms and conservative treatment.
abstract: An 83 years old physician, doing only office work and no exercise, presented with cauda equine, due to a large intervertebral disk hernia between L1-L2 vertebrae, after an unorthodox movement. He also had a facet syndrome, a muscular spasm in the gluteus, a small fracture in the periphery of the body of the L2 vertebra and pain in the L4-L5, due to a previous vertebral hernia five years ago. All L1-L5 left lateral area was painful. He felt an unbearable pain. He also had a degree of paralysis of the gastrointestinal (GI) and the genitourinary system. He could not take analgesics or anti-inflammatory drugs per os because of the paralysis of the GI system. His pain was relieved only by intramuscular injections of parecoximbe (a cyclooxigenase-2 inhibitor, COX-2). The disc hernia was treated without surgery. After 43 days in bed, he was able to start exercising in order to treat muscles' atrophy.
authors.affiliation: Ermou 51str, P.C. 54623, Thessaloniki, Greece. fgrammat@auth.gr.
authors.forename: Philip
authors.initials: P
authors.lastname: Grammaticos
authors.forename: Nikitas
authors.initials: N
authors.lastname: Papadopoulos
authors.forename: Labib
authors.initials: L
authors.lastname: Tarazi
authors.forename: Dimosthenis
authors.initials: D
authors.lastname: Katsarkas
mesh_terms: D000369:Aged, 80 and over; D004632:Emergency Medical Services / Q000379:methods*; D019317:Evidence-Based Medicine; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D011128:Polyradiculopathy / Q000175:diagnosis* / Q000209:etiology / Q000628:therapy*; D063189:Symptom Assessment / Q000379:methods*; D016896:Treatment Outcome