Oncotarget

Research Papers:

Analysis of clinical and neurological outcomes in patients with cauda equina syndrome caused by acute lumbar disc herniation: a retrospective-prospective study

Si-Dong Yang, Feng Zhang and Wen-Yuan Ding _

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Oncotarget. 2017; 8:84204-84209. https://doi.org/10.18632/oncotarget.20453

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Abstract

Si-Dong Yang1,*, Feng Zhang2,* and Wen-Yuan Ding1,3

1Department of Spinal Surgery, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, PR China

2Department of Rehabilitation Medicine, The Third Hospital of Hebei Medical University, Shijiazhuang, 050051, PR China

3Hebei Provincial Key Laboratory of Orthopaedic Biomechanics, Shijiazhuang, 050051, PR China

*These authors have contributed equally to this work

Correspondence to:

Wen-Yuan Ding, email: [email protected]

Keywords: cauda equina syndrome, lumbar disc herniation, spine, risk factor

Received: May 26, 2017    Accepted: July 26, 2017    Published: August 24, 2017

ABSTRACT

Objectives: In this research we analyzed the results of surgical treatment of cauda equina syndrome (CES) caused by acute lumbar disc herniation. We emphasize the early treatment for good neurological recovery.

Methods: A retrospective-prospective, non randomized, clinical study was performed between Jan 2010 and Dec 2014. We retrospectively collected medical records of 18 patients who suffered from CES due to acute lumbar disc herniation and followed up them regularly. Visual analogue scale (VAS) score, lumbar JOA score (29 points), RR (recovery rate) and Oswestry disability index (ODI) questionnaire were used to evaluate clinical outcomes.

Results: All patients were followed up for at least two years. Lumbar disc herniation is located at L2-3 level in 2 cases, L3-4 level in 2 cases, L4-5 level in 9 cases, L5-S1 level in 5 cases. VAS score is 6±2.5 preoperatively and 1.5±1.0 postoperatively at last follow-up (P<0.001). JOA score is 5±3.5 preoperatively, while it is 20±7 postoperatively at last follow-up (P<0.001). RR ≥ 50% was found in 12 cases. ODI is 75%±25% preoperatively, while it becomes 28%±16% postoperatively at last follow-up (P<0.001). It also shows that advanced age (≥45 years) may act as a risk factor for poor RR(<50%), while early operation (duration before surgery, <48 h) proves to be a protective factor.

Conclusions: Early operations are mandatory and closely relevant to final outcomes for CES patients. However, elder patients are more likely to have poor clinical effect after surgery.


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