scholarly journals Prediction of the outcome of bladder dysfunction based on electrically induced reflex findings in patients with cauda equina syndrome

Medicine ◽  
2017 ◽  
Vol 96 (21) ◽  
pp. e7014 ◽  
Author(s):  
Dong Gyu Lee ◽  
Sang Gyu Kwak ◽  
Min Cheol Chang
Keyword(s):  
Cauda Equina Syndrome ◽  
Bladder Dysfunction ◽  
Cauda Equina

Long-term rates of bladder dysfunction after decompression in patients with cauda equina syndrome

2021 ◽  
Author(s):  
Henry Seidel ◽  
Sarah Bhattacharjee ◽  
Sean Pirkle ◽  
Lewis Shi ◽  
Jason Strelzow ◽  
...  
Keyword(s):  
Cauda Equina Syndrome ◽  
Bladder Dysfunction ◽  
Cauda Equina

scholarly journals Physical Examination Is Predictive of Cauda Equina Syndrome: MRI to Rule Out Diagnosis Is Unnecessary

2020 ◽  
pp. 219256822094880
Author(s):  
Natalie L. Zusman ◽  
Stephanie S. Radoslovich ◽  
Spencer B. S. Smith ◽  
Mary Tanski ◽  
Kenneth R. Gundle ◽  
...  
Keyword(s):  
Physical Examination ◽  
Cauda Equina Syndrome ◽  
Bladder Dysfunction ◽  
Medical Center ◽  
Academic Medical Center ◽  
Effective Means ◽  
Cauda Equina ◽  
Cross Sectional ◽  
Predictive Values ◽  
Rectal Tone

Study Design: Cross-sectional cohort study. Objectives: Cauda equina syndrome (CES) is a neurologic emergency, and delay in diagnosis can result in irreversible impairment. Our purpose was to determine the value of physical examination in diagnosis of CES in patients complaining of bladder and/or bowel complications in the emergency department. Methods: Adult patients at one tertiary academic medical center that endorsed bowel/bladder dysfunction, underwent a lumbar magnetic resonance imaging (MRI), and received an orthopedic spine surgery consultation from 2008 to 2017 were included. Patients consulted for trauma or tumor were excluded. A chart and imaging review was performed to collect demographic, physical examination, and treatment data. Sensitivity, specificity, and negative and positive predictive values were calculated, and fast-and-frugal decision trees (FFTs) were generated using R. Results: Of 142 eligible patients, 10 were diagnosed with CES. The sensitivity and specificity of the exam findings were highest for bulbocavernosus reflex (BCR) (100% and 100%), followed by rectal tone (80% and 86%), postvoid residual bladder (80% and 59%), and perianal sensation (60% and 68%). The positive predictive value was high for BCR (100%), but low for other findings (13% to 31%). However, negative predictive values were consistently high for all examinations (96% to 100%). Two FFTs utilizing combinations of voluntary rectal tone, perianal sensation, and BCR resulted in no false negatives. Conclusions: A combination of physical examination findings of lower sacral function is an effective means of ruling out CES and, with further study, may eliminate the need for MRI in many patients reporting back pain and bowel or bladder dysfunction.

scholarly journals Cauda equina syndrome caused by primary and metastatic neoplasms

2004 ◽  
Vol 16 (6) ◽  
pp. 1-18 ◽  
Author(s):  
Carlos A. Bagley ◽  
Ziya L. Gokaslan
Keyword(s):  
Cauda Equina Syndrome ◽  
Bladder Dysfunction ◽  
Cauda Equina ◽  
Low Back ◽  
Disc Protrusion ◽  
Secondary Neoplasms ◽  
Lower Extremity Weakness ◽  
Nonsurgical Management ◽  
Bowel And Bladder Dysfunction ◽  
Tumor Types

Cauda equina syndrome (CES) is defined as the constellation of symptoms that includes low-back pain, sciatica, saddle anesthesia, decreased rectal tone and perineal reflexes, bowel and bladder dysfunction, and variable amounts of lower-extremity weakness. There are several causes of this syndrome including trauma, central disc protrusion, hemorrhage, and neoplastic invasion. In this manuscript the authors reviewed CES in the setting of both primary and secondary neoplasms. They examined the various primary tumor types in this region as well as those representative of metastatic spread. Both surgical and nonsurgical management in this setting were studied.

scholarly journals Sexual and Bladder Dysfunction in Cauda Equina Syndrome: Correlation with Clinical and Urodynamic Studies

2020 ◽  
Vol 14 (6) ◽  
pp. 782-789
Author(s):  
Gururaj Sangondimath ◽  
Abhinandan Reddy Mallepally ◽  
Amrithlal Mascharenhas ◽  
Harvinder Singh Chhabra
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Cauda Equina Syndrome ◽  
Bladder Dysfunction ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Bladder Function ◽  
Leg Pain ◽  
Motor Weakness ◽  
Urodynamic Studies

Study Design: Retrospective cohort study.Purpose: To analyze the clinical and sphincteric outcomes and the extent of sexual dysfunction (SD) in subjects with cauda equina syndrome (CES) and to assess their correlation with patient-reported and clinical/urodynamic parameters.Overview of Literature: Despite vast literature present for CES, extent of the problem of SD in CES patients has not received enough attention as reflected by the limited information in literature. Little is known about exact prevalence at presentation or about the recovery. A better understanding of SD and bladder dysfunction in CES secondary to lumbar disc herniation is essential as it commonly occurs in the sexually active age group.Methods: All cases of cauda equine syndrome secondary to lumbar disc herniation were recruited. Biographical and clinical data, history, examination findings, operative variables, recovery, and SD were noted. Water cystometry and uroflowmetry were done pre- and postoperatively. The International Index of Erectile Function questionnaire and Female Sexual Function Index were used to assess SD among the men and women, respectively.Results: A total of 43 patients with up to 2.94-year follow-up were included. Urodynamic studies were found to correlate significantly with age, days of bladder involvement, perianal numbness, and motor weakness (<i>p</i><0.01). In step-wise regression analysis, perianal sensation and overall motor weakness were bladder function determinants. Bladder function recovery was directly related to the number of delay days (<i>t</i>=2.30, <i>p</i><0.05) and with unilateral leg pain (<i>t</i>=2.15, <i>p</i><0.05). Significant correlation between SD with age and days of bladder involvement before surgery was found (<i>p</i><0.01).Conclusions: Surgery timing is related to patient’s functional and sexual outcomes. Patients with unilateral leg pain and hypocontractile bladder have better outcomes. SD is a remarkable problem in CES.

scholarly journals A scoping review protocol: Investigating the extent and legal process of cauda equina syndrome claims for UK physiotherapists

2021 ◽  
Author(s):  
Rachel L. Leech ◽  
James Selfe ◽  
Suzanne Ball ◽  
Susan Greenhalgh ◽  
Gareth Hogan ◽  
...  
Keyword(s):  
Scoping Review ◽  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Legal Process ◽  
Review Protocol

scholarly journals Bilateral triceps surae muscle focal myositis after a cauda equina syndrome

2021 ◽  
Author(s):  
G.R. González Toledo ◽  
H. Pérez Pérez ◽  
L. Brage Martín ◽  
V. Castro López-Tarruella
Keyword(s):  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Triceps Surae ◽  
Triceps Surae Muscle

scholarly journals Acute bilateral foot drop with or without cauda equina syndrome—a case series

2021 ◽  
Vol 163 (4) ◽  
pp. 1191-1198
Author(s):  
Andreas K. Demetriades ◽  
Marco Mancuso-Marcello ◽  
Asfand Baig Mirza ◽  
Joseph Frantzias ◽  
David A. Bell ◽  
...  
Keyword(s):  
Cauda Equina Syndrome ◽  
Cauda Equina ◽  
Case Series ◽  
Foot Drop ◽  
Spinal Disease ◽  
Full Resolution ◽  
Degenerative Spinal Disease ◽  
The Mean ◽  
The One

Abstract Introduction Isolated acute bilateral foot drop due to degenerative spine disease is an extremely rare neurosurgical presentation, whilst the literature is rich with accounts of chronic bilateral foot drop occurring as a sequela of systemic illnesses. We present, to our knowledge, the largest case series of acute bilateral foot drop, with trauma and relevant systemic illness excluded. Methods Data from three different centres had been collected at the time of historic treatment, and records were subsequently reviewed retrospectively, documenting the clinical presentation, radiological level of compression, timing of surgery, and degree of neurological recovery. Results Seven patients are presented. The mean age at presentation was 52.1 years (range 41–66). All patients but one were male. All had a painful radiculopathic presentation. Relevant discopathy was observed from L2/3 to L5/S1, the commonest level being L3/4. Five were treated within 24 h of presentation, and two within 48 h. Three had concomitant cauda equina syndrome; of these, the first two made a full motor recovery, one by 6 weeks follow-up and the second on the same-day post-op evaluation. Overall, five out of seven cases had full resolution of their ankle dorsiflexion pareses. One patient with 1/5 power has not improved. Another with 1/5 weakness improved to normal on the one side and to 3/5 on the other. Conclusion When bilateral foot drop occurs acutely, we encourage the consideration of degenerative spinal disease. Relevant discopathy was observed from L2/3 to L5/S1; aberrant innervation may be at play. Cauda equina syndrome is not necessarily associated with acute bilateral foot drop. The prognosis seems to be pretty good with respect to recovery of the foot drop, especially if partial at presentation and if treated within 48 h.

scholarly journals Surgical decompressions for cauda equina syndrome during COVID-19

2020 ◽  
pp. 1-3
Author(s):  
Nithish Jayakumar ◽  
Lucie Ferguson ◽  
Justin Nissen ◽  
Damian Holliman
Keyword(s):  
Cauda Equina Syndrome ◽  
Cauda Equina

scholarly journals 307 Improving Compliance with Standard of Care Guidelines for Suspected Cauda Equina Syndrome Across A District General Hospital Network

2021 ◽  
Vol 108 (Supplement_2) ◽  
Author(s):  
D Richardson ◽  
F Greenway ◽  
A Mostofi ◽  
E Pereira
Keyword(s):  
Cauda Equina Syndrome ◽  
Guideline Implementation ◽  
Cauda Equina ◽  
Clinical Information ◽  
Standard Of Care ◽  
District General Hospital ◽  
Service Improvement ◽  
Local Policy ◽  
National Guidelines ◽  
Care Guidelines

Abstract Introduction Cauda equina syndrome (CES) is a spinal emergency that cannot be reliably detected through clinical examination alone and as a result requires prompt MR imaging to provide a diagnosis. This audit examined compliance to standard of care following service improvements in line with the updated SBNS/BASS national guidelines for CES. Method A retrospective analysis of 200 patients referred to neurosurgery for suspected CES: 100 pre- and 100 post-service improvement SBNS guideline implementation. The online neurosurgical database was reviewed, cases assessed for completeness of referral information (including appropriate exam and pre-referral MRI) with patient demographics, referring hospital and outcome also recorded. Results Prior to the SBNS guidelines only 19 patients received MRI prior to referral, 70% of all referrals were incomplete or contained erroneous clinical information. Post-service improvements there was a 68% increase of pre-referral MRI (32 cases), and an improvement in quality of clinical information with only 19% of referrals providing insufficient or unreliable information. Conclusions Through relatively simple changes to local policy, patient care flow and education of emergency department clinicians we have significantly improved pre-referral MRI rates as well as overall referral quality across the whole DGH network.

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