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Asian Spine J. 2013 Sep;7(3):232-5. doi: 10.4184/asj.2013.7.3.232. Epub 2013 Sep 4.

Delayed diagnosis of cauda eqina syndrome with perineural cyst after combined spinal-epidural anesthesia in hemodialysis patient.

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Department of Orthopaedic Surgery, Oyamada Memorial Spa Hospital, Yokkaichi, Japan.


Symptomatic Tarlov (perineural cysts) are uncommon. In the following hemodialysis case, cauda equina syndrome was not detected after combined spinal-epidural anesthesia untilthe patient reported a lack of sensation in the perianal area 14 days postoperatively. She had normal motor function of her extremities. A laminectomy and cyst irrigation was performed. After the operation, her sphincter disturbance subsided gradually and her symptoms had disappeared.


Cauda eqina syndrome; Hemodialysis; Perineural cyst

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