Time Issue and Disc Herniation Dimension: Are They Actually Predictive for Consequence of Urinary Dysfunction in Sufferers With Cauda Equina Syndrome?
Neurosurgery. 2018 Feb 06;:
Authors: Kaiser R, Nasto LA, Venkatesan M, Waldauf P, Perez B, Stokes OM, Haddad S, Mehdian H, Tsegaye M
Summary
BACKGROUND: Timing of surgical procedure and the significance of the dimensions of disc prolapse in cauda equina syndrome (CES) stay controversial.
OBJECTIVE: To research whether or not there’s a relationship between postoperative urinary perform, preoperative period of neurogenic decrease urinary tract dysfunction (NLUTD), and the extent of canal compromise.
METHODS: Seventy-one sufferers operated for CES have been prospectively recognized between 2010 and 2013. Fifty-two circumstances with preoperative NLUTD have been included. The “Prolapse: Canal ratio” (PCR) was calculated as a proportion of cross-sectional space of disc prolapse on whole cross-sectional space of spinal canal.
RESULTS: Median of preoperative period of NLUTD was 72 h (48; 132) and interval from first evaluation to surgical procedure 10.5 h (7; 18.5). Urinary incontinence was seen in 46.2% of sufferers, 38.four% had painless retention and 15.four% had painful retention. In 38.5% of circumstances, urinary signs persevered for greater than 20 mo postoperatively. There was no correlation between period of preoperative NLUTD and urinary dysfunction persistence (P = .921). The result was not considerably influenced by having surgical procedure greater than the 48 h after presentation (P = .135). Preoperative incontinence persevered in 58% and painless retention in 30% of circumstances. The imply PCR was zero.6 ± zero.18. There was no correlation between PCR and end result (P = .537) even after adjusting for period of preoperative NLUTD (P = .7264).
CONCLUSION: No important correlation was demonstrated between the preoperative period of urinary dysfunction, the dimensions of disc herniation relative to dimension of spinal canal, and postoperative urinary perform in a big consecutive sequence of sufferers with CES.
PMID: 29425362 [PubMed – as supplied by publisher]