A correlation of demographic characteristics, preoperative conservative therapy and timing with postoperative outcome in herniated disc-associated cauda equina syndrome: Do they really matter?

Abstract

<p><strong>Aim </strong><br />To examine a correlation of demographic characteristics of patients, preoperative modality of conservative therapy and timing on the postoperative outcome of patients six months after the operation.<br /><strong>Methods</strong> <br />A retrospective, non-randomized, clinical study involved 48 patients of different age and gender with a verified diagnosis of<br />cauda equina syndrome (CES). The inclusion criteria were patients with CES caused by discus hernia. Observed research variables were age, gender, affected vertebral level, conservative modalities of perioperative therapy (nonsteroidal anti-inflammatory drugs - NSAIDs and physiotherapy), duration of symptoms, and outcome parameters (motor and sensory function, sphincter function of the urinary bladder and bowel).<br /><strong>Results</strong> <br />A statistically significant negative correlation was found between age and postoperative outcome (p<0.05). The affected<br />vertebral level was positively correlated with the motor and sensory outcome (p<0.05). A positive correlation between the use of NSAIDs and the outcome was found (R=0.570; p<0.001), as well as a negative correlation with perioperative physiotherapy (R=-0.201; p= 0.001). Postponement of surgery was negatively correlated with outcome variables (p<0.001).<br /><strong>Conclusion</strong> <br />The results of the study bring new conclusions that<br />were not previously observed. Possible new characteristics associated with the outcome of cauda equina syndrome were determined.</p>

Spinal Cord Syndrome Due to Extramedullary Epithelioid Hemangioendothelioma of the Thoracic Spine: A Case Report and Literature Review

“…Weakness and sensitive disturbances in the upper limbs are found in cervical tumors, and patients with thoracic and lumbar tumors report spasticity, weakness, and sensory disturbances in the lower limbs [ 36 ]. Also, cauda equina syndrome is caused when compression at the levels of L3/L4 and L4/L5 occurs [ 37 ].…”

Biphasic Calcium Phosphate Bone Graft With a Unique Surface Topography: A Single-Center Ambispective Study for Degenerative Disease of the Lumbar Spine

“…Depending on the condition and the severity of symptoms, adverse events may be managed conservatively or require additional surgical intervention. As an example, cauda equina syndrome, although rare, is severe and requires urgent surgical treatment [ 28 ], while other conditions, such as pseudoarthrosis, typically occur at a later time point from the initial surgery and are treated conservatively for a period of time, allowing for delayed healing. Pseudoarthrosis is a challenging complication in lumbar arthrodesis surgery and often occurs within one year of the index procedure [ 29 ].…”

Isolated Transverse Process Fractures: Should We Offer Lumbar Corset or Not?

“…The use of nonsteroidal anti-inflammatory drugs (NSAIDs) in spinal pathologies affects the VAS scores in a positive way. Likewise, Beculic et al indicated that preoperative use of NSAIDs as a conservative therapy for herniated disc-associated cauda equina syndrome affects the outcome assertively [ 30 ]. We found that publications in the literature on this type of spinal fracture have a common consensus regarding conservative treatment.…”

“…We found that publications in the literature on this type of spinal fracture have a common consensus regarding conservative treatment. This similarity is related to medical treatment targeting myofascial muscle damage and appropriate dosage of medication (anti-inflammatory drugs, muscle relaxants, and others) [ 1 , 2 , 5 , 15 , 16 , 30 ].…”