The Impact of Pre-operative Time Interval on the Treatment of Discogenic Cauda Equina Syndrome

Czech version

Authors: I. Lukáč; I. J. Šulla
Authors‘ workplace: Neurochirurgická klinika LF UPJŠ a FNLP Košice
Published in: Cesk Slov Neurol N 2010; 73/106(5): 523-528
Category: Original Paper

Overview

Cauda equina syndrome (CES) is disease that occurs predominantly in people of productive age, frequently involving serious consequences. The authors evaluated a group of 101 patients treated for CES over a period of 12 years (1996–2007) and followed the dynamics of the development of symptoms in terms of etiology. At a minimum of one year after the completion of treatment (when the condition of the patients was stable), all subjects were invited for checkup examination. Correlations were established between the influence of the pre-operative time interval, i.e. the period between the onset of disease and surgical decompression of neural structures, and the persistence of pain, the restoration of sensitivity and re-establishment of sphincter function. Based on data derived from a group of 68 patients (from a total of 101) with discogenic CES, those who presented for checkup or returned a questionnaire, and statistical analyses (χ² test, and in situations with values of 5 or less, Fisher exact test) the authors concluded that preoperative time interval had no influence on the outcomes for patients in the group studied. It is interesting to note that preoperative time interval was dependent on the etiology of CES – it was at its shortest in the patients with free sequester or large pieces of intervertebral disc sequesters herniated into the spinal canal. Symptoms of CES arising out of spinal stenosis developed more slowly. The slowest development of symptoms was observed in patients with CES caused by neoplasms.

Key words:
cauda equina syndrome – operation timing

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