Cauda equina syndrome: evaluation of the clinical outcome

Cauda equina syndrome is a rare but highly impairing syndrome involving lower limbs as well as urinary, defecatory and sexual function. In the literature the most investigated sphincter dysfunction is the urinary. Bowel and sexual function are often overlooked since they become more relevant after t...

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Bibliographic Details
Published inEuropean review for medical and pharmacological sciences Vol. 18; no. 7; p. 1098
Main Authors Tamburrelli, F C, Genitiempo, M, Bochicchio, M, Donisi, L, Ratto, C
Format Journal Article
LanguageEnglish
Published Italy 2014
Subjects
Adult
Defecation
Humans
Intervertebral Disc Displacement - surgery
Laminectomy
Lumbar Vertebrae
Male
Manometry
Middle Aged
Polyradiculopathy - diagnosis
Polyradiculopathy - physiopathology
Postoperative Complications - diagnosis
Postoperative Complications - physiopathology
Young Adult
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Summary:Cauda equina syndrome is a rare but highly impairing syndrome involving lower limbs as well as urinary, defecatory and sexual function. In the literature the most investigated sphincter dysfunction is the urinary. Bowel and sexual function are often overlooked since they become more relevant after the acute phase. Eight consecutive male patients affected by cauda equina syndrome with sphincter dysfunction due to herniated disc disease of lumbar spine were treated between 2007 and 2009. Five patients were followed-up for at least two years. Sexual function was evaluated by IIEF-5 questionnaire; bowel function was investigated by means of clinical and instrumental investigation and manometry. Although little clinical improved, patients still complained severe symptoms at first year follow-up while all but one improved significantly in the following year. At two years follow-up only the patient whose cauda equina syndrome was misdiagnosed and surgically treated late respect to the onset of the syndrome, complained a persistent severe sexual and bowel dysfunction. Our results show that a long-term follow-up is mandatory to evaluate the real outcome of surgical managed cauda equine syndrome because short-term evaluation could be misleading about the residual capacity of late neurologic improving. Despite the relatively low number of cases evaluated, our results confirm that early diagnosing and treating the syndrome are relevant for the final outcome.
ISSN:2284-0729