Cauda Equina Syndrome: prognostic factors and surgical outcome | ||
| Pan Arab Journal of Neurosurgery | ||
| Article 5, Volume 20, Issue 1, June 2025, Pages 21-29 PDF (982.28 K) | ||
| Document Type: Original Articles | ||
| DOI: 10.21608/pajn.2024.302042.1138 | ||
| Authors | ||
| Amr Mohamed Tayel* 1; Ali Rabee Kamel Hemdan2; Islam elmalky3; Abdelhakeem Essa4 | ||
| 1South Valley University, faculty of medicine, neurosurgery department, Qena, Egypt | ||
| 2Neurosurgery department, Faculty of medicine, South Valley University | ||
| 3Neurology department, Faculty of medicine, South Valley University. | ||
| 4Neurosurgery department, Faculty of medicine, Assiut University | ||
| Abstract | ||
| Background: Cauda equina syndrome (CES) is a neurosurgical emergency resulting in one or more of the following: bladder, bowel, and/or sexual dysfunction, decreased saddle area sensation, and motor and/or sensory neurological deficit in the lower limbs. Objective: This study was done to assess the clinical outcome following surgery for CES syndrome and to detect the prognostic factors. Patients and Methods: This study was conducted with 30 patients admitted to Qena University Hospitals. Patients over 18 years old with clinical and radiological evidence of CES were included. Patients must have urinary and/or anal dysfunction, the cause of CES is herniated lumbar disc with or without canal stenosis, and the levels affected are L3-4 or lower, either single or multiple. Results: The mean age was 43.2 years. 21 had American Society of Anesthesiologists (ASA) grade I. The mean Visual Analogue Scale (VAS) was 2.27±2.16. Urological symptoms were evident among the studied population. Saddle area sensation was normal in 10. The British Medical Research Council (BMRC) scale was of grade 4 in most cases. L4/5 was the most affected level. The time till operation was 63.97±6.8 hours. Postoperatively, most cases had 0 VAS and BMRC grade 5. BMRC and ASA were associated with quality of life (QOL). Conclusion: CES is a neurosurgical emergency with outcomes indicated by features such as sciatic pain, bladder function, and surgery performed within 24 hours of bladder dysfunction onset. Recovery of neurological deficits may take months to years, particularly for micturition dysfunction, emphasizing the need for longer-term follow-up. | ||
| Keywords | ||
| cauda equine syndrome incomplete (CESI); cauda equine syndrome complete with urinary retention (CESR); Visual Analogue Scale (VAS); British Medical Research Council (BMRC); timing of surgery | ||
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