Department of Radiology and Nuclear Medicine, Fukushima Medical University School of Medicine.
Department of Radiology, Fukushima Medical University Hospital.
Fukushima J Med Sci. 2022;68(2):135-141. doi: 10.5387/fms.2022-12.
Lumbar spinal canal stenosis (LSS) is a common spinal disorder among older people. Some LSS patients say that their pain worsens when they lift heavy objects. The Valsalva maneuver is the optimal breathing pattern for producing maximal force. Herein, we present two cases of LSS where the movement of the cauda equina was observed during the Valsalva maneuver.Case Summary:Case 1: A 74-year-old female with a history of LSS presented to our Department of Urology with frequent urination. The patient was diagnosed as having uterine and bladder prolapse. Pelvic cine MRI scan was conducted for detailed evaluation. While the Valsalva maneuver was performed to diagnose pelvic organ prolapses, we observed movement of the cauda equina. Spine MRI and CT, performed one year before presentation, showed severe LSS due to degenerative spondylolisthesis.Case 2: A 73-year-old male underwent radical prostatectomy for prostate cancer. A follow-up cine MRI to confirm urethrorrhea showed the cauda equina moving during the Valsalva maneuver. Moderate LSS due to degenerative spondylolisthesis was retrospectively found on abdominal CT performed before prostatectomy.Conclusion: The findings of our report suggest that movement of the cauda equina during the Valsalva maneuver may be implicated in LSS.
腰椎管狭窄症（LSS）是老年人中常见的脊柱疾病。一些 LSS 患者表示，他们在提起重物时疼痛会加剧。瓦尔萨尔瓦动作是产生最大力量的最佳呼吸模式。在此，我们报告两例 LSS 患者在进行瓦尔萨尔瓦动作时观察到马尾神经的运动。
病例 1：一名 74 岁女性，有 LSS 病史，因频繁排尿就诊于我院泌尿科。患者被诊断为子宫和膀胱脱垂。为详细评估，进行了盆腔 cine MRI 扫描。在进行诊断盆腔器官脱垂的瓦尔萨尔瓦动作时，我们观察到马尾神经的运动。脊柱 MRI 和 CT 检查显示，一年前表现出严重的 LSS 是由于退行性脊椎滑脱引起的。
病例 2：一名 73 岁男性因前列腺癌接受根治性前列腺切除术。为确认尿道漏尿进行了随访 cine MRI，显示在瓦尔萨尔瓦动作时马尾神经移动。在前列腺切除术之前进行的腹部 CT 检查发现存在退行性脊椎滑脱引起的中度 LSS。
我们的报告结果表明，瓦尔萨尔瓦动作时马尾神经的运动可能与 LSS 有关。
