Redundant Nerve Root Syndrome of Cauda Equina

Objective: Recognizing cauda equina redundant nerve root syndrome is crucial before surgery. Magnetic resonance imaging (MRI) findings of this condition are demonstrated. The aim of this study is to identify patients with redundant nerve root syndrome (RNS), well demonstrate (MRI) findings, notify the surgeon before the surgery and therefore to prevent a potential catastrophe. Methods: Ten patients (age range 59-87; mean age 74; 5 males and 5 females) with clinical symptoms of back pain, progressive leg numbness, pain and paresthesia on lower sensory dermatomes were diagnosed as redundant nerve root syndrome of cauda equina by MRI and clinical findings in our institution in two years prospective evaluation. In the same time period, 575 lumbar MRI was performed for patients who presented with low back pain in our clinic. Results: Magnetic resonance imaging findings revealed severe extradural lumbar spinal canal stenosis and tortuous, elongated, enlarged nerve roots in all ten patients with redundant nerve root syndrome of cauda equina. Conclusions: Severe extradural lumbar spinal stenosis may represent itself with large, elongated and tortuous nerve roots. This is probably secondary to acquired elongation of nerve roots due to mechanical trapping at the level of lumbar spinal stenosis. Cause is possibly a squeezing force due to chronic compression. Magnetic resonance imaging and MR myelography findings of several redundant nerve root syndrome of cauda equina cases are presented with clinical impression in this study.