Coccygeal fracture and Paget's disease presenting as acute cauda equina syndrome

Paget's disease of bone affects a significant percentage of adult and elder ly patients. Although generally asymptomatic, the inflammatory changes and hypervascularity of the affected bone is prone to pathologic fracture and r esultant hemorrhage. Epidural hematoma is well-described with vertebral fra ctures and can present as acute cauda equina syndrome. We describe a case i n which an elderly female with Paget's disease sustained a minor coccygeal fracture and developed local hemorrhage and edema, which caused a sacral pl exopathy that presented identical to acute cauda equina syndrome. A literat ure review will follow, (C) 1999 Elsevier Science Inc.