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Case Reports
. 2017 Sep;16(3):236-241.
doi: 10.1016/j.jcm.2017.02.001. Epub 2017 Apr 7.

Redundant Nerve Root in a Patient With Chronic Lumbar Degenerative Canal Stenosis

Federico E Villafañe  1 , Allison Harvey  2 , Norman Kettner  1
Affiliations
Case Reports

Redundant Nerve Root in a Patient With Chronic Lumbar Degenerative Canal Stenosis

Federico E Villafañe et al. J Chiropr Med. 2017 Sep.

Abstract

Objective: The purpose of this case report is to describe the diagnostic imaging features of redundant nerve roots caused by chronic lumbar degenerative canal stenosis (CLDCS).

Clinical features: A 56-year-old male presented with severe low back pain. He experienced pain during minimal active lumbar range of motion. The patient demonstrated weakness of the right iliopsoas and hypoesthesia of the L-2 dermatome. A working diagnosis of CLDCS was established. The patient's worsening severe low back pain warranted magnetic resonance imaging of the lumbar spine, which was performed for further evaluation. Magnetic resonance imaging demonstrated disk protrusion and canal stenosis with tortuosity of the cauda equina consistent with redundant nerve root appearance.

Intervention and outcome: The patient was treated with chiropractic flexion distraction, which was followed by a course of acupuncture and spinal manipulation. The patient self-discharged following clinical improvement.

Conclusions: This case demonstrated CLDCS with associated redundant nerve roots. Conservative treatment included chiropractic diversified lumbar spinal manipulation, acupuncture, and electrical stimulation. The patient self-discharged following clinical improvement in 3 months.

Keywords: Canal Stenosis; Cauda Equina; Lumbar Spine; Redundant Nerve Root.

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Figures

Fig. 1
Fig 1
A, Sagittal T2-weighted magnetic resonance imaging (MRI) scan demonstrates degenerative changes of the lumbar spine with disk herniation and vertebral canal stenosis at L2/L3 and L4/L5 (arrows). Elongated and tortuous nerve roots of the cauda equina can be identified (arrowhead). B, Zoom demonstrating the redundant nerve roots (arrowhead). C, Axial T2-weighted MRI scan at the L2/L3 level demonstrating disk herniation with ventral thecal sac compression (arrow).
Fig. 2
Fig 2
Normal canal with nerve roots (left) and lumbar canal stenosis with redundant nerve roots (right).
Fig. 3
Fig 3
A, Intraoperative view demonstrates normal appearance of the cauda equina. Reproduced with permission from Fabrizio Pignotti. B, Presence of tortuous, elongated and engorged nerve roots of the cauda equina. Reproduced with permission from Tayfun Hakan.
See this image and copyright information in PMC

References

    1. Savarese L., Ferreira-Neto G., Herrero C., Defino H., Noqueira-Barbosa M. Cauda equine redundant nerve root are associated to the degree of spinal stenosis and to spondylolisthesis. Arq Neuropsiquiatr. 2014;72(10):782–787. - PubMed
    1. Tsuji H, Tamaki T, Itoh T. Redundant nerve roots in patients with degenerative lumbar spinal stenosis. Spine. 1985;10(1):72–82. - PubMed
    1. Tomita K. Diagnosis and treatment of lumbar spine canal stenosis. JMAJ. 2003;46(10):439–444.
    1. Hakan T, Celikoglu E, Aydoseli A, Demir K. The redundant nerve root syndrome of the cauda equina. Turk Neurosurg. 2008;18(2):204–206. - PubMed
    1. Fritsch C, Ferreira M, Maher C. The clinical course of pain and disability following surgery for spinal stenosis: a systematic review and meta-analysis of cohort studies. Eur Spine J. 2017;26(2):324–335. - PubMed

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