Incidence and long-term patient reported outcome measures of patients with radiological cauda equina compression but without clinical features of cauda equina syndrome
Background: Cauda equina syndrome (CES) is a rare spinal emergency. Paradoxically, in the British NHS, suspected CES requiring an emergency magnetic resonance imaging constitutes one of the commonest reasons for acute referrals to neurosurgery/spine surgery. Further acute referrals also occur with t...
Saved in:
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wolters Kluwer Medknow Publications
2024-12-01
|
| Series: | Journal of Craniovertebral Junction and Spine |
| Subjects: | |
| Online Access: | https://journals.lww.com/10.4103/jcvjs.jcvjs_132_24 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832087258271842304 |
|---|---|
| author | Hamzah Alsheikh Soleiman Mary Solou Andreas K. Demetriades |
| author_facet | Hamzah Alsheikh Soleiman Mary Solou Andreas K. Demetriades |
| author_sort | Hamzah Alsheikh Soleiman |
| collection | DOAJ |
| description | Background:
Cauda equina syndrome (CES) is a rare spinal emergency. Paradoxically, in the British NHS, suspected CES requiring an emergency magnetic resonance imaging constitutes one of the commonest reasons for acute referrals to neurosurgery/spine surgery. Further acute referrals also occur with the reverse scenario, when radiological evidence of cauda equina compression is not accompanied by the clinical red flags of the syndrome. The understanding of CES, particularly in cases with radiological compression but lacking clinical symptoms, remains limited. This study aims to explore the incidence and the long-term outcomes of such patients, addressing a significant knowledge gap.
Methods:
A single-center, retrospective and cohort study was conducted, analyzing suspected CES referrals managed between August 2013 and November 2014. Patients with radiological cauda equina compression but without clinical CES features were identified. A structured questionnaire assessed long-term patient reported outcomes.
Results:
Out of 344 suspected CES referrals, 38 patients (11%) had radiological CES of degenerative cause without clinical symptoms. From those with radiological cauda equina compression but no features of CES, 14 were assessed for long-term results and the majority still underwent surgery (64%), either emergent (35.7%) or elective (28.6%). The long-term patient reported outcomes of the operated patients revealed that 66.7% were fully ambulant, 77.8% maintained an intact sexual function, and 88.9% were free of urinary symptoms. However, no matter the management, chronic pain persisted in 85.7%.
Conclusion:
This study highlights the existence of patients who are referred urgently with radiological cauda equina compression but who lack clinical CES symptoms. Despite surgical interventions, chronic pain remains a significant issue. Further research, including multi-centered studies, is warranted to enhance our understanding of this condition and its nuanced subpopulations. |
| format | Article |
| id | doaj-art-c00b23e49d23403599f40280ce9fd816 |
| institution | Kabale University |
| issn | 0974-8237 0976-9285 |
| language | English |
| publishDate | 2024-12-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Craniovertebral Junction and Spine |
| spelling | doaj-art-c00b23e49d23403599f40280ce9fd8162025-02-06T06:11:06ZengWolters Kluwer Medknow PublicationsJournal of Craniovertebral Junction and Spine0974-82370976-92852024-12-0115448249110.4103/jcvjs.jcvjs_132_24Incidence and long-term patient reported outcome measures of patients with radiological cauda equina compression but without clinical features of cauda equina syndromeHamzah Alsheikh SoleimanMary SolouAndreas K. DemetriadesBackground: Cauda equina syndrome (CES) is a rare spinal emergency. Paradoxically, in the British NHS, suspected CES requiring an emergency magnetic resonance imaging constitutes one of the commonest reasons for acute referrals to neurosurgery/spine surgery. Further acute referrals also occur with the reverse scenario, when radiological evidence of cauda equina compression is not accompanied by the clinical red flags of the syndrome. The understanding of CES, particularly in cases with radiological compression but lacking clinical symptoms, remains limited. This study aims to explore the incidence and the long-term outcomes of such patients, addressing a significant knowledge gap. Methods: A single-center, retrospective and cohort study was conducted, analyzing suspected CES referrals managed between August 2013 and November 2014. Patients with radiological cauda equina compression but without clinical CES features were identified. A structured questionnaire assessed long-term patient reported outcomes. Results: Out of 344 suspected CES referrals, 38 patients (11%) had radiological CES of degenerative cause without clinical symptoms. From those with radiological cauda equina compression but no features of CES, 14 were assessed for long-term results and the majority still underwent surgery (64%), either emergent (35.7%) or elective (28.6%). The long-term patient reported outcomes of the operated patients revealed that 66.7% were fully ambulant, 77.8% maintained an intact sexual function, and 88.9% were free of urinary symptoms. However, no matter the management, chronic pain persisted in 85.7%. Conclusion: This study highlights the existence of patients who are referred urgently with radiological cauda equina compression but who lack clinical CES symptoms. Despite surgical interventions, chronic pain remains a significant issue. Further research, including multi-centered studies, is warranted to enhance our understanding of this condition and its nuanced subpopulations.https://journals.lww.com/10.4103/jcvjs.jcvjs_132_24cauda equina syndromedisc herniationlumbar spinelumbar stenosisradiological compression |
| spellingShingle | Hamzah Alsheikh Soleiman Mary Solou Andreas K. Demetriades Incidence and long-term patient reported outcome measures of patients with radiological cauda equina compression but without clinical features of cauda equina syndrome Journal of Craniovertebral Junction and Spine cauda equina syndrome disc herniation lumbar spine lumbar stenosis radiological compression |
| title | Incidence and long-term patient reported outcome measures of patients with radiological cauda equina compression but without clinical features of cauda equina syndrome |
| title_full | Incidence and long-term patient reported outcome measures of patients with radiological cauda equina compression but without clinical features of cauda equina syndrome |
| title_fullStr | Incidence and long-term patient reported outcome measures of patients with radiological cauda equina compression but without clinical features of cauda equina syndrome |
| title_full_unstemmed | Incidence and long-term patient reported outcome measures of patients with radiological cauda equina compression but without clinical features of cauda equina syndrome |
| title_short | Incidence and long-term patient reported outcome measures of patients with radiological cauda equina compression but without clinical features of cauda equina syndrome |
| title_sort | incidence and long term patient reported outcome measures of patients with radiological cauda equina compression but without clinical features of cauda equina syndrome |
| topic | cauda equina syndrome disc herniation lumbar spine lumbar stenosis radiological compression |
| url | https://journals.lww.com/10.4103/jcvjs.jcvjs_132_24 |
| work_keys_str_mv | AT hamzahalsheikhsoleiman incidenceandlongtermpatientreportedoutcomemeasuresofpatientswithradiologicalcaudaequinacompressionbutwithoutclinicalfeaturesofcaudaequinasyndrome AT marysolou incidenceandlongtermpatientreportedoutcomemeasuresofpatientswithradiologicalcaudaequinacompressionbutwithoutclinicalfeaturesofcaudaequinasyndrome AT andreaskdemetriades incidenceandlongtermpatientreportedoutcomemeasuresofpatientswithradiologicalcaudaequinacompressionbutwithoutclinicalfeaturesofcaudaequinasyndrome |