Cauda equina nerve damage is more common in clinic. Most of it is caused by absolute or relative narrowing of lumbar spinal canal and compression of cauda equina nerve, resulting in a series of nerve dysfunction. Verbiest's first clinical report in 1949 was named Cauda equina syndrome CES.
Central canal stenosis leads to compression of cauda equina nerve, which leads to hypoesthesia in saddle area and sphincter dysfunction. Developmental lumbar spinal stenosis is the primary pathological basis of CES.
Ankylosing spondylitis is rarely associated with neurological complications in the early and middle stages. Late stage can be combined with cauda equina syndrome, so far, more than 60 cases of this kind of report have been accumulated in the world. It is believed that ankylosing spondylitis can be combined with arachnoiditis, and then diverticular cysts are formed and enlarged, resulting in enlargement of the spinal canal, compressive defects of the posterior vertebral body, the vertebral arch and the lamina, formation of arachnoid cysts, compression of the conus medullaris or/and cauda equina. The clinical manifestation is CES, which is a long process. Coscia et al. used CT and MRI techniques to study these patients and reached the same conclusion.
Degenerative dislocation of lumbar spine or lumbar fracture, degenerative spondylolisthesis of lumbar spine often causes spinal canal stenosis. At this time, the lower edge of the lamina and the ligamentum flavum attached to the relaxed lamina become thicker and the ridge of bone proliferate. The cauda equina nerve and nerve root can be compressed by the fibrous tissue surrounding the dura and lateral recess.
Marhouitz et al. reported that manipulative massage caused spinal spondylolisthesis and cauda equina nerve compression leading to CES. Fractures of the vertebral body or appendages, fragments or broken intervertebral discs occupy the space of the spinal canal and directly compress the cauda equina nerve.
Fracture fragments can also penetrate into the dura an