Details

Autor(en) / Beteiligte

• Julie Woodfield
• Josephine Jung
• Simon Lammy
• Cathal J. Hannan
• Anna Watts
• Richard D.C. Moon
• Holly Roy
• Phillip C. Copley
• Michael T.C. Poon
• Nisaharan Srikandarajah
• Andreas K. Demetriades
• Niall Eames
• Philip J. Sell
• Patrick F.X. Statham
• Usman Ahmed
• Qasim Ajmi
• Rafid Al-Mahfoudh
• Meriem Amarouche
• Amin Andalib
• Mohit Arora
• Mukul Arora
• Iwan Bennett
• Imran Bhatti
• Lalasa Bommireddy
• Alexandros Boukas
• James Bourne
• Rachael Brennan
• Oliver Burton
• Christopher Busby
• Neil Chiverton
• Simon Clark
• Simon Cudlip
• Stacey Darwish
• Benjamin Davies
• Andreas K Demetriades
• Saurabh Deore
• Chris Derham
• Muhammad Dherijha
• Gareth Dobson
• Andrew Durnford
• Alexander ZE Durst
• Edward W Dyson
• Anne Elserius
• Becca Elson
• Mohammed Fadelalla
• Daniel M Fountain
• Adrian Gardner
• James R Gill
• Robin Gordon
• Rebecca Grenfell
• Tim Hammett
• Cathal John Hannan
• Ingrid Hoeritzauer
• David Holmes
• Kismet Hossain-Ibrahim
• Muhammad Hussain
• Shakir Hussain
• Aimun AB Jamjoom
• Muhammad Khan
• Ashwin Kumaria
• Roberta LaCava
• Alistair Lawrence
• Matthew Lea
• Ignatius Liew
• Weisang Luo
• James Manfield
• Joseph Merola
• Pranav Mishra
• Khalid Abubaker Mohmoud
• Richard Moon
• Rory Morrison
• Odhran Murray
• Ali Nader-Sepahi
• Anand Pandit
• Nitin Patel
• Anita Philip
• Michael TC Poon
• Kuskoor Seethram Manjunath Prasad
• Savva Pronin
• Balaji Purushothaman
• Kapil Rajwani
• Fahid Tariq Rasul
• Moritz Schramm
• Gabrielle Scicluna
• Philip J Sell
• Himanshu Sharma
• Asim Sheikh
• Vinothan Sivasubramaniam
• Agbolahan Sofela
• George Spink
• Euan Strachan
• Chrishan Thakar
• Christian Ulbricht
• David White
• Kathrin Whitehouse

Titel

Presentation, management, and outcomes of cauda equina syndrome up to one year after surgery, using clinician and participant reporting: A multi-centre prospective cohort studyResearch in context

Ist Teil von

• The Lancet regional health. Europe, 2023-01, Vol.24, p.100545

Ort / Verlag

Elsevier

Erscheinungsjahr

2023

Link zum Volltext

Quelle

Elektronische Zeitschriftenbibliothek

Beschreibungen/Notizen

• Background: Cauda equina syndrome (CES) results from nerve root compression in the lumbosacral spine, usually due to a prolapsed intervertebral disc. Evidence for management of CES is limited by its infrequent occurrence and lack of standardised clinical definitions and outcome measures. Methods: This is a prospective multi-centre observational cohort study of adults with CES in the UK. We assessed presentation, investigation, management, and all Core Outcome Set domains up to one year post-operatively using clinician and participant reporting. Univariable and multivariable associations with the Oswestry Disability Index (ODI) and urinary outcomes were investigated. Findings: In 621 participants with CES, catheterisation for urinary retention was required pre-operatively in 31% (191/615). At discharge, only 13% (78/616) required a catheter. Median time to surgery from symptom onset was 3 days (IQR:1–8) with 32% (175/545) undergoing surgery within 48 h. Earlier surgery was associated with catheterisation (OR:2.2, 95%CI:1.5–3.3) but not with admission ODI or radiological compression. In multivariable analyses catheter requirement at discharge was associated with pre-operative catheterisation (OR:10.6, 95%CI:5.8–20.4) and one-year ODI was associated with presentation ODI (r = 0.3, 95%CI:0.2–0.4), but neither outcome was associated with time to surgery or radiological compression. Additional healthcare services were required by 65% (320/490) during one year follow up. Interpretation: Post-operative functional improvement occurred even in those presenting with urinary retention. There was no association between outcomes and time to surgery in this observational study. Significant healthcare needs remained post-operatively. Funding: DCN Endowment Fund funded study administration. Castor EDC provided database use. No other study funding was received.