Non-compressive postoperative cauda equina syndrome following decompression and transforaminal interbody fusion surgery.

Postoperative cauda equina syndrome (CES) is a known rare complication following lumbar disc surgery. Seldom are they seen following decompression for spinal stenosis and may be actually more frequent and under-reported? Emergent surgical exploration remains the mainstay of management as the factors responsible for postop CES remains a variety of compressive forces. Yet many a time postoperative imaging or surgical exploration fails to identify a pathology and this leads to an ischaemic theory responsible for CES. Our article highlights conservative management in these selective group. We share our experience in two cases of incomplete CES during our routine transforaminal interbody fusion which we followed closely without re-exploration eventually ending in a favourable outcome. Key messages: The factors responsible for postop CES remains mostly a variety of compressive forces though in some instances postoperative imaging or surgical exploration fails to identify such in some cases. This leads to an ischaemic theory responsible for CES. The role of conservative management of postoperative CES in certain selective cases has a favourable outcome as illustrated in our cases.