Iranian Journal of Neurosurgery (Jan 2018)
Prognosis of Cauda Equina Syndrome Caused by Herniated Disk After Lumbar Disk Operation
Abstract
Background and Aim: Although operation is the most appropriate treatment for Cauda Equina Syndrome, the effectiveness of operation on clinical symptoms is still under discussion. This study aimed to determine the prognosis of Cauda Equina Syndrome in patients with lumbar disk surgery in Al-Zahra Hospital of Isfahan City, Iran, from 2013 to 2015. Methods and Materials/ Patients: In This prospective study, patients diagnosed with Cauda Equina Syndrome who underwent operation in Al-Zahra Hospital of Isfahan from 2013 to 2015 were followed up for two years and the effect of the surgery on the improvement of their clinical symptoms was investigated. Results: In this study, 33 patients with Cauda Equina Syndrome were evaluated. About 24-month follow-up of patients showed muscle weakness improvement in 26(78.8%) of them. Of all 19 patients with urinary dysfunction, 18(94.7%) recovered. Six (33.3%) cases improved the day after surgery, 6(33.3%) cases in one month, 4(22.2%) cases in six months, and 2(11.1%) cases within 24 months after the surgery. All 4(100%) patients with bowl disorder also recovered during the study. One (25%) of them improved the day after operation, 1(25%) one month after the operation and 2(50%) within 24 months following the operation. Conclusion: According to the results of this study, operation of the lumbar disks leads to improvement of Cauda Equina Syndrome, including recovery of sphincter disorders and muscle weakness, but considering the limitations of our investigation (including a small sample size), further studies are recommended in this area.