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Review paper

A correlation of demographic characteristics, preoperative conservative therapy and timing with postoperative outcome in herniated disc-associated cauda equina syndrome: Do they really matter?

By
Hakija Bečulić Orcid logo ,
Hakija Bečulić

Deparment of Neurosurgery, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Department of Anatomy, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

Emir Begagić ,
Emir Begagić
Contact Emir Begagić

Deparment of General Medicine, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

Rasim Skomorac ,
Rasim Skomorac

Deparment of Neurosurgery, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Department of Anatomy, School of Medicine, University of Zenica,

Aldin Jusić ,
Aldin Jusić

Deparment of Neurosurgery, Cantonal Hospital Zenica, Zenica, Bosnia and Herzegovina

Alma Efendić ,
Alma Efendić

Deparment of General Medicine, School of Medicine, University of Zenica,

Department of Radiology, Cantonal Hospital Zenica,

Edin Selimović ,
Edin Selimović

Deparment of General Medicine, School of Medicine, University of Zenica, Zenica, Bosnia and Herzegovina

Primary Health Care Centre Zenica,

Anes Mašović ,
Anes Mašović

Deparment of Neurosurgery, Cantonal Hospital Zenica,

Lejla Bečulić
Lejla Bečulić

Zenica-Doboj Canton, Institute for Occupational Medicine and Sports Medicine,

Abstract

Aim
To examine a correlation of demographic characteristics of patients, preoperative modality of conservative therapy and timing on the postoperative outcome of patients six months after the operation.
Methods
A retrospective, non-randomized, clinical study involved 48 patients of different age and gender with a verified diagnosis of
cauda equina syndrome (CES). The inclusion criteria were patients with CES caused by discus hernia. Observed research variables were age, gender, affected vertebral level, conservative modalities of perioperative therapy (nonsteroidal anti-inflammatory drugs - NSAIDs and physiotherapy), duration of symptoms, and outcome parameters (motor and sensory function, sphincter function of the urinary bladder and bowel).
Results
A statistically significant negative correlation was found between age and postoperative outcome (p<0.05). The affected
vertebral level was positively correlated with the motor and sensory outcome (p<0.05). A positive correlation between the use of NSAIDs and the outcome was found (R=0.570; p<0.001), as well as a negative correlation with perioperative physiotherapy (R=-0.201; p= 0.001). Postponement of surgery was negatively correlated with outcome variables (p<0.001).
Conclusion
The results of the study bring new conclusions that
were not previously observed. Possible new characteristics associated with the outcome of cauda equina syndrome were determined.

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