Cauda Equina Compressed by Bratpfannen-Like Vertebra rather than Protruded Disc: An Unusual Radiographic Images in a Lady with Severe Osteoporosis

1 Department of Medical Education, Taichung Veterans General Hospital, Taiwan

2 Department of Radiology, Taichung Veterans General Hospital, Taiwan

3 Department of Physical Therapy, College of Medical and Health Care, Hungkuang University, Taiwan

4 Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital, Taiwan

5 Department of Physical Medicine and Rehabilitation, Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taiwan

6 Department of Medicine, Chung Shan Medical University, Taiwan

Received: Oct 28, 2019

Published: Nov 15, 2019

^*Correspondence Author: Department of Physical Medicine and Rehabilitation, Taichung Veterans General Hospital/Tri-Service General Hospital, School of Medicine, National Defense Medical Center, Taipei, Taiwan. E-mail: [email protected].

# Hong YH and Wang GJ contributed equally and acted as the co-first author.

Copyright © 2019 Chang ST.

Citation: Chang ST. (2019). Cauda Equina Compressed by Bratpfannen-Like Vertebra rather than Protruded Disc: An Unusual Radiographic Images in a Lady with Severe Osteoporosis. Mathews J Case Rep 4(4): 60.

ABSTRACT

Burst fracture of lumbar spine may cause cauda equina syndrome to present varying neurological symptoms. The structure causing compression of cauda equina has been known as a herniated disc. Other structures resulted in such compression were rare mentioned. Here, we present an unusual condition with cauda equina compressed by a bratpfannen-like vertebra, rather than a protruded disc. A 76-year-old female with a history of osteoporosis and falling episode 1 year ago presenting with lower back pain for 3 months and a 3-day history of bilateral legs weakness with urinary and stool incontinence. This patient displayed decreased muscle power of bilateral lower limbs, as well as saddle anesthesia and decreased anal tone. Image revealed showed a severe burst fracture with neartotal loss of height in the second lumbar vertebral body (L2), a bratpfannen-like deformity, which abuts to compress the dural sac of cauda equine, not a common herniated disc. The patient underwent subsequent surgical intervention soon. Symptoms relieved 3 weeks later. In summary, we believe the meanings of the distinct features are different from conventional concept when facing such unusual representations.

Keywords: Cauda Equina; Bratpfannen-Like Vertebra; Prolapsed Lumbar; Osteoporosis; Vertebroplasty.