Cauda equina syndrome: An analysis of incidence rates and risk factors among a closed North American military population

Schoenfeld, Andrew J.; Bader, Julia

doi:10.1016/j.clineuro.2012.02.012

Cited by 30 publications

(24 citation statements)

References 15 publications

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“…Several techniques have been reported to achieve a complete transposition of the VA [15][16][17][18][19][20]. We have also used the stitched sling retraction technique to mobilize the VA [4].…”

Section: Discussionmentioning

confidence: 97%

Outcome of microvascular decompression for hemifacial spasm associated with the vertebral artery

et al. 2016

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We retrospectively compared the outcome of microvascular decompression (MVD) for hemifacial spasm (HFS) associated with the vertebral artery (VA) with that of MVD for HFS unrelated to the VA. Between April 2008 and April 2015, 22 patients with VA-associated HFS underwent MVD at our institution. The median follow-up period was 28 months (range, 12-90 months). Results were classified as excellent in 19 patients (86 %), good in one (5 %), fair in one (5 %), and poor in one (5 %). Immediate complications developed in five patients (23 %), and one of these complications (5 %) was permanent. The surgical outcome of MVD for VA-associated HFS was similar to that of MVD for HFS unrelated to the VA; however, the incidence of complications was significantly more frequent in patients whose VA compressed the more proximal portion of the facial nerve root exit zone from the caudal side at the pontomedullary sulcus. We conclude that preoperative evaluation of VA compression patterns is important to predict the difficulty of the planned MVD procedure.

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Section: Discussionmentioning

confidence: 97%

Outcome of microvascular decompression for hemifacial spasm associated with the vertebral artery

et al. 2016

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“…The pooled OR estimate in the meta-analysis maintained a 63% increase in postoperative odds of death for males compared with females. This may be reflective of underlying physiologic differences between the sexes as well as variation in the number and severity of medical comorbidities [45,46,56,58]. Females are known to have lower rates of coronary artery disease, peripheral vascular disease, and renal dysfunction [58].…”

Section: Discussionmentioning

confidence: 99%

“…Distinct differences in tobacco and alcohol abuse as well as risk-taking behavior might also elevate the odds of postoperative death or the development of specific complications such as surgical site infection (SSI). Sexbased differences with respect to the incidence of specific spinal disorders have previously been described, including lumbar degenerative disc disease [49], lumbar radiculopathy [48], and cauda equina syndrome [45]. Furthermore, previous work [55] has identified that males are more likely than females to receive recommendations for spine surgery despite similar underlying disorders [55].…”

Section: Introductionmentioning

confidence: 99%

Does Patient Sex Affect the Rate of Mortality and Complications After Spine Surgery? A Systematic Review

Schoenfeld

Reamer

Wynkoop

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Available studies disagree regarding the influence of patient sex on mortality and complications after spine surgery. We sought to conduct a systematic review and pool the results of existing research to better understand this issue. Questions/purposes We performed a systematic review to address two questions: (1) Does sex (male versus female) influence mortality after spine surgery? (2) Does sex impact the development of postoperative complications after spine surgery?Methods This systematic review was performed through a query of PubMed using a structured search algorithm. Additional queries of Embase, SCOPUS, Web of Science, and the tables of contents of orthopaedic and neurosurgical journals were also conducted using search terms such as ''sex factors'', ''male or female'', ''risk factors'', and ''spine surgery''. Selected papers were independently abstracted by three of the authors (AJS, ENR, EIW) and pooling was performed. Our literature search returned 720 studies, of which 99 underwent full review. Of these, 50 were selected for final abstraction. The Cochrane Q test was used to assess study heterogeneity; significant study heterogeneity was present and so a random-effects model was used. A Harbord test was used to evaluate for the presence of publication bias; this analysis found no statistically significant evidence of publication bias. Results Males were at increased odds of mortality after spine surgery (odds ratio [OR], 1.63; 95% confidence interval [CI], p \ 0.001). No differences between the sexes were identified for the odds of complications (OR, 1.04; 95% CI, 0.95-1.13; p = 0.42). Conclusions Our results determined that males were at elevated odds of mortality but not of complications after spine surgery. These results should be used to inform preoperative discussion and decision-making at the time of surgical consent. Future work should be directed at determining the underlying factors responsible for increased

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“…The incidence quoted in the literature varies from 1 in 33 000 to 7 in 100 000 in a recent North American study 17 18. A review in Slovenia found an annual incidence of CES secondary to disc herniation of 1.8 per million population 19.…”

Section: Discussionmentioning

confidence: 99%

Cauda equina syndrome: the importance of complete multidisciplinary team management

Shivji

Tsegaye

2013

BMJ Case Reports

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A 44-year-old lady with a history of lumbar back pain presented to the emergency department complaining of severe back pain radiating to her buttocks. Positive examination findings were a loss of sensation in the perianal area and 348 ml of retained urine. An urgent MRI showed compression of the cauda equina by a herniated disc. The patient was operated upon that evening, having a lumbar 5/sacral 1 decompression and sequestrectomy. During follow-up, the patient was reviewed by a consultant spinal surgeon, a urologist and our cauda equina nurse at every appointment, as per the cauda equina pathway specifically designed and implemented by our spinal unit. This report shows the complex nature of cauda equina syndrome and broad functional deficit patients can suffer from. It shows the benefits of prompt diagnosis and surgery, together with intensive, multidisciplinary follow-up and treatment, all of which are possible by a specially created, cauda equina protocol.

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Cauda equina syndrome: An analysis of incidence rates and risk factors among a closed North American military population

Cited by 30 publications

References 15 publications

Outcome of microvascular decompression for hemifacial spasm associated with the vertebral artery

Outcome of microvascular decompression for hemifacial spasm associated with the vertebral artery

Does Patient Sex Affect the Rate of Mortality and Complications After Spine Surgery? A Systematic Review

Cauda equina syndrome: the importance of complete multidisciplinary team management

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