Asian Spine J.  2016 Oct;10(5):945-949. 10.4184/asj.2016.10.5.945.

Neurological Recovery in Two Patients with Cauda Equina Syndrome Secondary to L5 Lumbar Spine Giant Cell Tumour after Treatment with Denosumab without Surgery

• Randhawa S
• Kwan AK
• Chiu CK
• Chan CY
• Kwan MK

• KMID: 2354822
• DOI: http://doi.org/10.4184/asj.2016.10.5.945

Abstract

We report two patients with cauda equina syndrome (CES) secondary to L5 giant cell tumour (GCT) who achieved good neurological recovery after treatment with denosumab without surgery. The first patient was a 26-year-old man with L5 GCT causing CES who regained bowel and urinary control, muscle power improvement from grade 2 to grade 4 and Oswestry disability index (ODI) improvement from 48 to 23 after denosumab treatment. The second patient was a 25-year-old woman with L5 GCT causing CES who regained bowel and urinary control, muscle power improvement from grade 0 to grade 4 and ODI improvement from 42 to 20 after denosumab treatment. The usage of denosumab in the treatment of patients with CES due to GCT allows potential neurological recovery without any surgical intervention. If surgery is not contraindicated, more time is obtained to prepare the patient preoperatively to attain safer surgery and to achieve complete tumour clearance.

Keyword

Denosumab; Giant cell tumour; Cauda equina syndrome; Spine; Oncology

MeSH Terms

Adult
Cauda Equina*
Denosumab*
Female
Giant Cells*
Humans
Polyradiculopathy*
Spine*
Denosumab