Department of Neurosurgery, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina
Department of Neurosurgery, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina
Department of Neurosurgery, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina
Department of Neurosurgery, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina
Department of Emergency Medicine, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina
Department of Oncology and Radiotherapy, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina
Department of Radiology, Cantonal Hospital Zenica , Zenica , Bosnia and Herzegovina
Neurosurgery Clinic, University Clinical Centre , Tuzla , Bosnia and Herzegovina
Department of Surgery, General Hospital Tešanj , Tešanj , Bosnia and Herzegovina
Aim
To analyze the relationship between timing of surgery and outcome in patients with cauda equina syndrome caused by lumbar disc herniation.
Methods
A retrospective, non-randomized clinical study included 25 consecutive patients with cauda equina syndrome (CES) caused by lumbar disc herniation. All patients were operated within 24 hours after hospitalization at the Department of Neurosurgery, Cantonal Hospital Zenica, Bosnia and Herzegovina, between January 2000 and December 2010. All patients were evaluated before surgery on the basis of complete history, neurological examination and neuroimaging evaluations using CT (computed tomography) and MRI (magnetic resonance imaging).
Results
Statistically significant difference between preoperative and postoperative bladder (p=0.05) and bowel (p=0.05) function
was found. A significant number of patients had bladder and bowel recovery after surgery, nine (36%) and 11 (44%), respectively. Significant recovery of muscle strength was noted with complete recovery (5/5) in 12 (48%) and partial recovery in 13 (52%) patients. Complete sensory recovery was noted in 16 (64%), incomplete in four (16%), and in five (20%) patients there were no changes. Most commonly, patients with complete sensory recovery were operated within 48 hours of symptom onset. In most patients early surgery was associated with better outcome.
Conclusion
This research showed that early decompression correlated with better outcome. Patients with cauda equina syndrome
must be cleared for surgery in optimal conditions and, if it possible within optimal timing for recovery (within 48 hours).
This work is licensed under a Attribution-NonCommercial-NoDerivatives 4.0 International 
3
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