Asian Spine J.  2018 Dec;12(6):981-986. 10.31616/asj.2018.12.6.981.

Bladder Recovery Patterns in Patients with Complete Cauda Equina Syndrome: A Single-Center Study

Affiliations
  • 1Department of Spine Surgery, Indian Spinal Injuries Centre, New Delhi, India. Spineclinicdelhi@gmail.com

Abstract

STUDY DESIGN: Retrospective case series. PURPOSE: Cauda equina syndrome (CES) is associated with etiologies such as lumbar disc herniation (LDH) and lumbar canal stenosis (LCS). CES has a prevalence of 2% among patients with LDH and exhibits variable outcomes, even with early surgery. Few studies have explored the factors influencing the prognosis in terms of bladder function. Therefore, we aimed to assess the factors contributing to bladder recovery and propose a simplified bladder recovery classification. OVERVIEW OF LITERATURE: Few reports have described the prognostic clinical factors for bladder recovery following CES. Moreover, limited data are available regarding a meaningful bladder recovery status classification useful in clinical settings.
METHODS
A single-center retrospective study was conducted (April 2012 to April 2015). Patients with CES secondary to LDH or LCS were included. The retrieved data were evaluated for variables such as demographics, symptom duration, neurological symptoms, bladder symptoms, and surgery duration. The variable bladder function outcome during discharge and at follow-up was recorded. All subjects were followed up for at least 2 years. A simplified bladder recovery classification was proposed. Statistical analyses were performed to study the correlation between patient variables and bladder function outcome.
RESULTS
Overall, 39 patients were included in the study. Majority of the subjects were males (79.8%) with an average age of 44.4 years. CES secondary to LDH was most commonly seen (89.7%). Perianal sensation (PAS) showed a significant correlation with neurological recovery. In the absence of PAS, bladder function did not recover. Voluntary anal contraction (VAC) was affected in all study subjects.
CONCLUSIONS
Intactness of PAS was the only significant prognostic variable. Decreased or absent VAC was the most sensitive diagnostic marker of CES. We also proposed a simplified bladder recovery classification for recovery prognosis.

Keyword

Cauda equina syndrome; Neurogenic urinary bladder; Lumbar disc; Lumbar stenosis

MeSH Terms

Cauda Equina*
Classification
Constriction, Pathologic
Demography
Follow-Up Studies
Humans
Male
Polyradiculopathy*
Prevalence
Prognosis
Retrospective Studies
Sensation
Urinary Bladder*
Urinary Bladder, Neurogenic
Full Text Links
  • ASJ
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr