scholarly journals Improvement in Neurogenic Bowel and Bladder Dysfunction Following Posterior Decompression Surgery for Cauda Equina Syndrome: A Prospective Cohort Study

Neurospine ◽  
2021 ◽  
Vol 18 (4) ◽  
pp. 847-853
Author(s):  
Ryo Kanematsu ◽  
Junya Hanakita ◽  
Toshiyuki Takahashi ◽  
Manabu Minami ◽  
Tomoo Inoue ◽  
...  
Keyword(s):  
Cauda Equina Syndrome ◽  
Japanese Orthopaedic Association ◽  
Cauda Equina ◽  
Patient Characteristics ◽  
Bowel Dysfunction ◽  
Urinary Symptoms ◽  
Decompression Surgery ◽  
Posterior Decompression ◽  
Cord Injury ◽  
Neurogenic Bowel

Objective: The mechanisms of neurogenic bowel dysfunction (NBD) and neurogenic bladder (NB), which are major consequences of spinal cord injury and occasionally degenerative lumbar disease. The following in patients with cauda equina syndrome who underwent posterior decompression surgery was investigated: (1) the preoperative prevalence of NBD and NB, measured using the Constipation Scoring System (CSS) and International Prostate Symptoms Score (IPSS); (2) the degree and timing of postoperative improvement of NBD and NB.Methods: We administered the CSS and IPSS in 93 patients before surgery and at 1, 3, 6, and 12 months postoperatively. We prospectively examined patient characteristics, Japanese Orthopaedic Association (JOA) score, and postoperative improvements in each score.Results: The prevalence of symptomatic defecation and urinary symptoms at admission were 37 patients (38.1%) and 31 patients (33.3%), respectively. Among the symptomatic patients with defecation problems, 12 patients had improved at 1 month, 13 at 3 months, 14 at 6 months, and 13 at 12 months postoperatively. Among the symptomatic patients with urinary problems, 5 patients improved at 1 month, 11 at 3 months, 6 at 6 months, and 10 at 1 year postoperatively. Comparing patients with improved versus unimproved in CSS, the degree of JOA score improvement was a significant prognosis factor (p < 0.05; odds ratio, 1.05).Conclusion: The prevalence of symptomatic defecation and urinary symptoms in patients with cauda equina syndrome was 38.1% and 33.3%, respectively. Decompression surgery improved symptoms in 30%–50%. These effects were first observed 1 month after the operation and persisted up to 1 year.

scholarly journals Outcome of Delayed Decompression Surgery for Cauda Equina Syndrome secondary to Lumbar Disc Herniation: A Case Report

2020 ◽  
Vol 18 (2) ◽  
Author(s):  
Lim SM ◽  
Johari J ◽  
Yusof MI
Keyword(s):  
Lumbar Disc Herniation ◽  
Disc Herniation ◽  
Cauda Equina Syndrome ◽  
Lumbar Disc ◽  
Cauda Equina ◽  
Bowel Dysfunction ◽  
Decompression Surgery ◽  
Motor Weakness ◽  
Post Surgery ◽  
Maximum Improvement

Cauda equina syndrome (CES) is a constellation of symptoms which consist of low back pain, sciatica, saddlearea paraesthesia, urinary or faecal incontinence, with or without motor weakness, and sensory deficit. Surgical decompression is indicated as soon as possible, as decompression within 48 hours from onset allows maximum improvement of symptoms. Recovery usually occurs months or years postoperatively. We report a case of a patient with cauda equina syndrome secondary to massive lumbar disc herniation who had undergone urgent decompression one week after onset of urinary and bowel dysfunction. The clinical outcome post surgery was also discussed.

scholarly journals Efficacy of functional magnetic stimulation in neurogenic bowel dysfunction after spinal cord injury

2009 ◽  
Vol 41 (1) ◽  
pp. 41-47 ◽  
Author(s):  
PY Tsai ◽  
CP Wang ◽  
FY Chiu ◽  
YA Tsai ◽  
YC Chang ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Magnetic Stimulation ◽  
Bowel Dysfunction ◽  
Cord Injury ◽  
Neurogenic Bowel

scholarly journals Reliability, validity and sensitivity to change of neurogenic bowel dysfunction score in patients with spinal cord injury

Spinal Cord ◽  
2017 ◽  
Vol 55 (12) ◽  
pp. 1084-1087 ◽  
Author(s):  
D Erdem ◽  
D Hava ◽  
P Keskinoğlu ◽  
Ç Bircan ◽  
Ö Peker ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Bowel Dysfunction ◽  
Sensitivity To Change ◽  
Cord Injury ◽  
Neurogenic Bowel

scholarly journals Expediting the management of cauda equina syndrome in the emergency department through clinical pathway design

2019 ◽  
Vol 8 (4) ◽  
pp. e000597 ◽  
Author(s):  
Kevin G Buell ◽  
Sujan Sivasubramaniyam ◽  
Mark Sykes ◽  
Kamran Zafar ◽  
Lucy Bingham ◽  
...  
Keyword(s):  
Emergency Department ◽  
Clinical Pathway ◽  
Cauda Equina Syndrome ◽  
Primary Outcome ◽  
Cauda Equina ◽  
Neurological Dysfunction ◽  
Time Interval ◽  
Decompression Surgery ◽  
Retrospective Case ◽  
Pdsa Cycle

IntroductionCauda equina syndrome (CES) is a neurosurgical emergency. Early diagnosis with MRI and subsequent surgical decompression surgery can prevent permanent neurological dysfunction. Charing Cross Hospital (CXH) is a tertiary neurosurgical referral centre where in the emergency department (ED), current practice mandated a neurosurgery review prior to requesting MRI.HypothesisIt was hypothesised that a new clinical pathway, with better coordination from the ED, radiology and neurosurgical teams could reduce the time of presentation to diagnosis or exclusion of CES.MethodRetrospective case-note analysis of patients presenting with back pain to CXH ED over a 3-month period was performed. The primary outcome was the time interval between the patient’s arrival to the ED and the MRI preliminary report.ResultsThe baseline primary outcome was recorded at 8 hours and 16 min (n=30). A new clinical pathway was designed empowering ED senior decision makers to order MRIs prior to neurosurgical review. Two Plan-Do-Study-Act (PDSA) cycles were performed, each measured over a 2-month period. The first PDSA cycle was performed after the pathway was initially launched (n=17), while the second PDSA cycle measured the effect of staff education and active promotion of the pathway (n=17). MRI was requested earlier, waiting and reporting time for MRI were reduced. The exclusion or diagnosis of CES was reduced to 5 hours and 54 min in PDSA 1 and 5 hours 17 min in PDSA 2, a 29% and 36% reduction (p=0.048 and p=0.012, respectively).ConclusionThe clinical protocol was a cost-neutral and sustainable intervention that effectively reduced the time taken to diagnose or exclude CES and ED waiting times.

scholarly journals Prediction of severe neurogenic bowel dysfunction in persons with spinal cord injury

Spinal Cord ◽  
2010 ◽  
Vol 48 (7) ◽  
pp. 554-559 ◽  
Author(s):  
C-W Liu ◽  
C-C Huang ◽  
C-H Chen ◽  
Y-H Yang ◽  
T-W Chen ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Bowel Dysfunction ◽  
Cord Injury ◽  
Neurogenic Bowel
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