{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T20:25:16Z","timestamp":1789244716937,"version":"build-2803163510"},"reference-count":11,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground:<\/jats:title>\nSpinal cord infarction is rare and occurs in 12\/100,000; it represents 0.3%\u20132% of central nervous system infarcts. Here, we present a patient who developed recurrent bilateral lower extremity paraplegia secondary to spinal cord infarction 1 day after a successful L4-5 microdiscectomy in a patient who originally presented with a cauda equina syndrome.<\/jats:p>\n<\/jats:sec>\n\nCase Description:<\/jats:title>\nA 56-year-old patient presented with an acute cauda equina syndrome characterized by severe lower back pain, a right foot drop, saddle anesthesia, and acute urinary retention. When the lumbar magnetic resonance imaging (MRI) revealed a large right paracentral lumbar disc herniation at the L4-L5 level, the patient underwent an emergency minimally invasive right-sided L4-5 discectomy. Immediately, postoperatively, the patient regained normal function. However, 1 day later, while having a bowel movement, he immediately developed the recurrent paraplegia. The new lumbar MRI revealed acute ischemia and an infarct involving the distal conus medullaris. Further, workup was negative for a spinal cord vascular malformation, thus leaving an inflammatory postsurgical vasculitis as the primary etiology of delayed the conus medullaris infarction.<\/jats:p>\n<\/jats:sec>\n\nConclusions:<\/jats:title>\nAcute neurologic deterioration after spinal surgery which does not neurologically correlate with the operative level or procedure performed should prompt the performance of follow-up MR studies of the neuraxis to rule out other etiologies, including vascular lesions versus infarctions, as causes of new neurological deficits.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni-148-2019","type":"journal-article","created":{"date-parts":[[2019,8,25]],"date-time":"2019-08-25T12:02:39Z","timestamp":1566734559000},"page":"80","update-policy":"https:\/\/doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Spinal cord ischemia\/infarct after cauda equina syndrome from disc herniation \u2013 A case study and literature review"],"prefix":"10.25259","volume":"10","author":[{"given":"David C.","family":"Kramer","sequence":"first","affiliation":[{"name":"Department of Anesthesiology, Montefiore Medical Center, NY, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adela","family":"Aguirre-Alarcon","sequence":"additional","affiliation":[{"name":"Department of Anesthesiology, Montefiore Medical Center, NY, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reza","family":"Yassari","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Montefiore Medical Center, NY, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan L.","family":"Brook","sequence":"additional","affiliation":[{"name":"Department of Radiology, Montefiore Medical Center, NY, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merritt D.","family":"Kinon","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery, Montefiore Medical Center, NY, United States"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10894","published-online":{"date-parts":[[2019,5,10]]},"reference":[{"key":"10.25259\/SNI-148-2019\/ref-1","doi-asserted-by":"crossref","first-page":"1120","DOI":"10.4065\/76.11.1120","article-title":"Clinical and radiographic features of dural arteriovenous fistula, a treatable cause of myelopathy","volume":"76","author":"Atkinson","year":"2001","journal-title":"Mayo Clin Proc"},{"key":"10.25259\/SNI-148-2019\/ref-2","doi-asserted-by":"crossref","first-page":"E165","DOI":"10.1097\/01.BRS.0000058729.24510.C8","article-title":"Recurrent transverse myelitis after lumbar spine surgery:A case report","volume":"28","author":"Banit","year":"2003","journal-title":"Spine (Phila Pa 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