Recurrent adjacent segment disease and cauda equina syndrome

Purpose A case of cauda equina lesion as a result of recurrent adjacent segment degeneration (ASD) after multiple lumbar fusions is reported. ASD might be a consequence of biomechanical overload or simply a normal degenerative process. The reported clinical relevance of ASD is rather low. We describe an unusual case of cauda equina compression at L1–L2 in a patient who had undergone L2–L4 fusion 8 years previously and 2 decompression-fusion surgeries 16 years before.