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What is A 55 year male with complaints of urinary incontinence, severe back pain for 10days imaging shows lumbar disc prolapsed, no history of weight loss and fever. What is the diagnosis? and explain in detail?
*severe back pain with urinary incontinence in patient with H/o prolapsed interveebral disc is typical presention of cauda-equina syndrome. CAUDA EQUINA SYNDROME: compression of the lumbo-sacral nerve roots etiology traumatic: blunt/penetrating injury, post-operative atraumatic: central disc protrusion, tumour, epidural abscess, epidural hematoma, spinal stenosis symptoms: acute or gradual back pain, bilateral radiculopathy numb: perianal, bladder sensation weak: rectal incontinence, urinary retention, erectile dysfunction, lower extremity weakness diagnosis: MRI identify compression and cause (CT can miss disc, tumour, abscess, hematoma) treatment: urgent/emergent neurosurgical decompression Ref: millers review of ohopaedics - 7th/e p.677