Author's Name: |
Dr. Srikrishna Majhi, Dr. Sabyasachi Saha & Dr Anup Kumar Chaudhuri |
Subject Area: |
Health Science |
Subject |
Other |
Section |
Case Studies |
Keyword:
Cauda equina syndrome (CES), lumbar disc herniation, JOA recovery rate
Abstract
Objective: The primary objective of this study was to analyze the clinical and neurological outcomes in patients admitted with cauda equina syndrome (CES) at the Bangur Institute of Neuroscience, Kolkata, India from May 2018 to Oct 2019.
Methods: This was a single center prospective study done at Bangur Institute of Neuroscience, Kolkata, India from May 2018 to Oct 2019. Patients admitted with diagnosis of cauda equina syndrome were included in the study. The following variables were analyzed: gender, age, etiology of the disease, level of the injury, time interval between onset of symptoms and surgery, pre operative and post operative JOA (Japanese Orthopedic Association) score, Recovery Rate (RR) from JOA score.
Results: Overall, 32 patients were included in the study. Most of them were males (78 %) with an average age of 38.1 years. Most common cause of CES in our study was lumbar disc herniation and L4L5 level was most commonly involved. Only 6 patients (18%) presented before 48 hrs. When Recovery Rate (RR) was calculated it was found that only 12 patients (37.5%) had good recovery (RR 51-75%). When we calculated the association of different variables with recovery rate it was found that patients undergoing surgery in less than 48 hrs of symptom onset had good recovery rate (RR>50%) and the result is statistically significant (p value 0.018).
Conclusion: So the prospective observational study showed that Cauda equina syndrome is most commonly caused by lumbar prolapsed disc disease. There is significant delay in presentation which is caused by delay in diagnosis and referral. Better outcome in recovery rate was found in patients who presented to the health facility within 48 hrs and underwent surgery within 48 hrs.