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KMID : 0860920210230010011
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Journal of the Korean Association EMG-Electrodiagnostic Medicine
2021 Volume.23 No. 1 p.11 ~ p.14
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Cauda Equina Syndrome Caused by a Sacral Insufficiency Fracture in the Lower Part of Zones 2 and 3: A Case Report
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Cha Jun-Min
Kwon Nam-Woo
Lee Su-Ji
Lee Jang-Woo
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Abstract
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Sacral insufficiency fractures (SIFs) often cause referred low back pain, and are rarely accompanied by cauda equina syndrome (CES). We report a case of CES caused by SIF in the lower part of zones 2 and 3, which is not a typical location. A postmenopausal woman often sat on a chair for long periods, and pain in the coccyx and perianal area occurred. After 4 years, during which time the pain worsened and she developed urinary and fecal incontinence, magnetic resonance imaging showed a SIF involving the S3-S5 vertebrae. Prolonged latency of the bulbocavernosus reflex was confirmed through an electrodiagnostic study, and detrusor underactivity was confirmed through a urodynamic study, leading to a CES diagnosis. Unlike typical cases of osteoporotic SIF, the fracture occurred at an atypical location. We believe that long periods of sitting caused a different weight-bearing pattern of the sacrum from that found in typical cases.
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KEYWORD
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Fractures, stress, Cauda equina syndrome, Osteoporosis
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