Cauda Equina Syndrome Due to Lumbar Disc Herniation: a Review of Literature

Kapetanakis, Stylianos; Chaniotakis, Constantinos; Kazakos, Constantinos J; Papathanasiou, Jannis

doi:10.1515/folmed-2017-0038

Cited by 41 publications

(29 citation statements)

References 34 publications

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“…CES was first reported in 1934 by Mixter and Barr, who pioneered it via a transdural approach 20 . Individuals in their fourth and fifth decades of life are prone to LDH and progression to CES 2 , 21 . Our sample set for the study was mostly in their thirties, and men were more susceptible to be affected (n=13, 86.7%) than women.…”

Section: Discussionmentioning

confidence: 99%

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Cauda Equina Syndrome: A Review of 15 Patients Who Underwent Percutaneous Transforaminal Endoscopic Lumbar Discectomy (PTELD) Under Local Anaesthesia

Krishnan¹,

Kohli²,

Degulmadi³

et al. 2020

Malays Orthop J

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Introduction: To analyse the results of Cauda Equina Syndrome (CES) operated by Percutaneous Transforaminal Endoscopic Lumbar Discectomy (PTELD). Material and Methods: The study is a retrospective series of 15 patients operated by PTELD. Bladder dysfunction was classified as incomplete CES (CESI) and complete CES retention (CESR). Bladder / motor recovery rate and its timing, Oswestry Disability Index (ODI), Visual Analogue Score (VAS), patient satisfaction index, and sexual dysfunction were used to measure the outcome objectively. Additionally, in CESR patients, post-void residual (PVR) urine was measured by sonography. Complications and technical problems were noted. Results: There were ten patients of CESI and five patients of CESR. The average follow-up was 20.33(12.05) months. Bladder symptoms recovery was 100%, and motor recovery was 80%. VAS for back pain recovered to 0.53(0.52) from 8(2.39). VAS for leg pain recovered to 0.13(0.35) from 9.20(1.32). ODI improved to 6.07(2.85) from 77.52(13.20). The time to the recovery of bladder function was 1.47(1.55) days. All CESR patient’s abnormal PVR urine was normalised at five weeks post-operative. No complications were reported. However, five technical executional problems occurred. Conclusion: PTELD can be considered for CES treatment due to its substantial and quick recovery advantages. However, more evidence support is needed to make it a practice recommendation.

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Section: Discussionmentioning

confidence: 99%

“…Cauda equina syndrome (CES) is one of the most serious and complicated spinal pathologies 1 , 2 . It has been reported as the extreme presentation of 1-3% of Lumbar Disc Herniation (LDH) patients 2 - 4 . Conventionally, treatment for CES is open laminectomy/discectomy (MED: Microscopic Decompression) 5 .…”

Section: Introductionmentioning

confidence: 99%

Cauda Equina Syndrome: A Review of 15 Patients Who Underwent Percutaneous Transforaminal Endoscopic Lumbar Discectomy (PTELD) Under Local Anaesthesia

Krishnan¹,

Kohli²,

Degulmadi³

et al. 2020

Malays Orthop J

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“…Emergency surgical decompression within 48 hours of onset of symptoms is advised. 35,36 Surgery requires wide decompression (laminectomy + discectomy) using either open or microscopic approach. Endoscopic/ mini open approaches are contraindicated.…”

Section: Recurrent Disc Herniation (Figure 15)mentioning

confidence: 99%

Lumbar Disc Herniation: A review article

Jain¹,

Mathur²,

Sharma³

et al. 2020

IJOR

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Nearly 80% of the population sustains an episode of low back pain (LBP) once during their lifetime. Within the vast differential of LBP, the most common source is intervertebral disc degeneration leading to degenerative disc disease (DDD) and lumbar disc herniation (LDH). Thus, an effective understanding of LDH, its origins, and how to appropriately treat it is of substantial importance. Through this article we try to dispel some uncertainties about disc herniation and study in detail its aetiology, treatments available, their indications and their clinical outcomes.

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“…Most patients presenting with acute symptoms of cauda equina compression suffer from extensive disc prolapses compressing the cauda equina nerve roots 1 , 2 or show evidence of a decompensated spinal canal obstruction 3 . Treatment should be performed within a short time margin and requires emergency magnetic resonance imaging (MRI) to confirm the diagnosis, followed by prompt surgical decompression 3 – 5 .…”

Section: Introductionmentioning

confidence: 99%

Body mass index has an impact on preoperative symptoms but not clinical outcome in acute cauda equina syndrome

Butenschoen

Abulhala

Meyer

2021

Sci Rep

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Cauda equina syndrome (CES) presents a surgical emergency with treatment required within 48 h. Symptoms include reduced saddle sensation, micturition difficulties, and/or anal sphincter impairment. Controversy exists regarding the effect on and coincidence of overweight with CES. We performed a retrospective case–control study of all patients treated surgically for acute complete and incomplete CES in our neurosurgical department from 2009 to 2020, focusing on the preoperative BMI and postoperative neurological outcome. In addition, we performed a comprehensive literature review. Fifty patients with CES were included, of whom 96% suffered from a decompensated lumbar spinal stenosis or disc prolapse between the L4/5 and L5/S1 levels. Our cohort population was overweight but not obese: mean BMI was 27.5 kg/m2, compared with 27.6 kg/m2 in patients with degenerative spine surgery. BMI did not significantly influence the postoperative outcome, but it did affect preoperative symptoms and surgery duration. Symptom duration significantly differed depending on the underlying cause for CES. The literature review revealed sparse evidence, with only four clinical case series presenting contradictory results. We provide a comprehensive literature review on the current evidence regarding CES and obesity and conclude that we did not observe an association between obesity and CES occurrence. Patients with CES and other degenerative spinal pathologies belong to an overweight but not obese population. Body Mass Index has an impact on preoperative symptoms but not clinical outcome in acute CES.

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Cauda Equina Syndrome Due to Lumbar Disc Herniation: a Review of Literature

Cited by 41 publications

References 34 publications

Cauda Equina Syndrome: A Review of 15 Patients Who Underwent Percutaneous Transforaminal Endoscopic Lumbar Discectomy (PTELD) Under Local Anaesthesia

Cauda Equina Syndrome: A Review of 15 Patients Who Underwent Percutaneous Transforaminal Endoscopic Lumbar Discectomy (PTELD) Under Local Anaesthesia

Lumbar Disc Herniation: A review article

Body mass index has an impact on preoperative symptoms but not clinical outcome in acute cauda equina syndrome

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