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Vol. 14. Issue 1.
Pages 52-53 (January 2003)
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Vol. 14. Issue 1.
Pages 52-53 (January 2003)
Síndrome de cauda secundario a estenosis y discitis en dos diferentes niveles raquídeos, diagnóstico por mielo-TC
Cauda syndrome due to spinal stenosis and diskytis in two different spinal levels. Diagnosis using myelo-TC
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R. Prat
, I. Galeano, F.J. Conde, P. Febles, S. Cortés, L. González-Feria
Servicio de Neurocirugía. Hospital Universitario de Canarias
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Resumen

Presentamos el caso de un paciente de 71 años de edad con clínica de paraparesia de varios meses de evolución incontinencia urinaria y anestesia en silla de montar, asociado a intensa lumbalgia y deterioro del estado general de varios días de evolución. La TC de raquis lumbosacro demuestra espondilodiscartrosis con lesión línea L5–S1. El estudio de resonancia magnética (RM) no pudo realizarse dado que el paciente era portador de marcapasos. La realización de mielo-TC permitió apreciar stop completo a nivel L4–L5 asociado a discitis L5–S1. Se llevó a cabo descompresión L4–L5 y discectomía L5–S1 obteniéndose una muestra compatible con discitis y osteomielitis. El presente caso tiene la originalidad de asociar dos lesiones en dos niveles distintos con cuadros clínicos independientes. Por otro lado la dificultad asociada de no poder realizar RM hizo de la mielo-TC un arma diagnóstica de gran utilidad.

Palabras clave:
Síndrome cauda equina
Discitis
Mielo-TAC
Summary

We report a case of a 75 year old man presenting with paraparesis, urinary incontinence and saddle anesthesia evolving after several months and severe lumbalgia and bad general status which developed fewdays before admission. CT-scan showed spondilosis with lytic lesion at L5–S1 level. MR1 was not performed because the patient had a pacemaker. A myelo-CT study was performed shuwing a complete stop at L4–L5 level together with L5–S1 diskytis. Laminectomy of L5 and discectomy L5–S1 was performed obtaining tissue sample diagnostic of diskytis and osteomyelitis. Our patient had two lesions at two different levels with two independent syndromic appearence. Myelo-CT played an important diagnostic role in this case because MRI study could not be obtained.

Key words:
Cauda syndrome
Diskytis
Myelo-CT

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