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Schwannoma of the cauda equina.
J Manipulative Physiol Ther. 1997 Feb; 20(2):124-9.JM

Abstract

OBJECTIVE

To review the features of spinal schwannoma in a case that mimicked a lumbar disc herniation.

CLINICAL FEATURES

A 37-yr-old woman suffered from a 4-yr history of progressive low back and leg pain, with progressive neurological involvement of several nerve roots. Noteworthy symptomatology included increased pain when lying recumbent and urinary and fecal incontinence. Several health care practitioners diagnosed her with a lumbar disc herniation. Investigations with myelography, computed tomography (CT) with myelographic contrast and magnetic resonance imaging (MRI) revealed the presence of an intradural tumor at the T12-L2 region.

INTERVENTION AND OUTCOME

The tumor was surgically resected via laminectomies at T12-L2. The patient experienced a decrease of pain intensity but continued to complain about the low back and posterior thigh pain and has been unable to return to work. She continues to suffer from urinary incontinence, which is controlled by medication. There has been no recurrence of the tumor.

CONCLUSION

Spinal pathology such as schwannoma of the cauda equina can mimic common complaints of low back pain seen in clinical practice. Differentiating features of cauda equina tumors from lumbar disc prolapse include: pain on lying recumbent, progressive nature of the pain and neurological deficit, involvement of several nerve root levels and intractability of the condition to conservative therapy. The most appropriate methods for imaging these tumors are CT with myelography or MRI. Patient prognosis is improved with early detection and removal. Chiropractors can play a pivotal role in the care of these patients by being suspicious of patients who do not respond as expected to a course of manipulative therapy, by investigating or referring appropriately and by aiding in active rehabilitation postoperatively.

Authors+Show Affiliations

Department of Graduate Studies and Research, Canadian Memorial Chiropractic College, Toronto, Ontario, Canada.No affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

9046461

Citation

Caputo, L A., and M D. Cusimano. "Schwannoma of the Cauda Equina." Journal of Manipulative and Physiological Therapeutics, vol. 20, no. 2, 1997, pp. 124-9.
Caputo LA, Cusimano MD. Schwannoma of the cauda equina. J Manipulative Physiol Ther. 1997;20(2):124-9.
Caputo, L. A., & Cusimano, M. D. (1997). Schwannoma of the cauda equina. Journal of Manipulative and Physiological Therapeutics, 20(2), 124-9.
Caputo LA, Cusimano MD. Schwannoma of the Cauda Equina. J Manipulative Physiol Ther. 1997;20(2):124-9. PubMed PMID: 9046461.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Schwannoma of the cauda equina. AU - Caputo,L A, AU - Cusimano,M D, PY - 1997/2/1/pubmed PY - 1997/2/1/medline PY - 1997/2/1/entrez SP - 124 EP - 9 JF - Journal of manipulative and physiological therapeutics JO - J Manipulative Physiol Ther VL - 20 IS - 2 N2 - OBJECTIVE: To review the features of spinal schwannoma in a case that mimicked a lumbar disc herniation. CLINICAL FEATURES: A 37-yr-old woman suffered from a 4-yr history of progressive low back and leg pain, with progressive neurological involvement of several nerve roots. Noteworthy symptomatology included increased pain when lying recumbent and urinary and fecal incontinence. Several health care practitioners diagnosed her with a lumbar disc herniation. Investigations with myelography, computed tomography (CT) with myelographic contrast and magnetic resonance imaging (MRI) revealed the presence of an intradural tumor at the T12-L2 region. INTERVENTION AND OUTCOME: The tumor was surgically resected via laminectomies at T12-L2. The patient experienced a decrease of pain intensity but continued to complain about the low back and posterior thigh pain and has been unable to return to work. She continues to suffer from urinary incontinence, which is controlled by medication. There has been no recurrence of the tumor. CONCLUSION: Spinal pathology such as schwannoma of the cauda equina can mimic common complaints of low back pain seen in clinical practice. Differentiating features of cauda equina tumors from lumbar disc prolapse include: pain on lying recumbent, progressive nature of the pain and neurological deficit, involvement of several nerve root levels and intractability of the condition to conservative therapy. The most appropriate methods for imaging these tumors are CT with myelography or MRI. Patient prognosis is improved with early detection and removal. Chiropractors can play a pivotal role in the care of these patients by being suspicious of patients who do not respond as expected to a course of manipulative therapy, by investigating or referring appropriately and by aiding in active rehabilitation postoperatively. SN - 0161-4754 UR - https://www.unboundmedicine.com/medline/citation/9046461/Schwannoma_of_the_cauda_equina_ L2 - http://www.diseaseinfosearch.org/result/6451 DB - PRIME DP - Unbound Medicine ER -