当前位置： SCI文献检索 > SPINE期刊下所有文献 > Cauda equina syndrome secondary to lumbar disc herniation: a meta-analysis of surgical outcomes.

Cauda equina syndrome secondary to lumbar disc herniation: a meta-analysis of surgical outcomes.

Abstract：

STUDY DESIGN:A meta-analysis of surgical outcomes of cauda equina syndrome secondary to lumbar disc herniation. OBJECTIVES:To determine the relationship between time to decompression after onset of cauda equina syndrome and clinical outcome, and to identify preoperative variables that were associated with outcomes. SUMMARY OF BACKGROUND DATA:The timing of surgical decompression for cauda equina syndrome is controversial. Although most surgeons recommend emergent decompression, results in certain studies show that delayed surgery may provide a satisfactory outcome. METHODS:A meta-analysis was performed to determine the correlation between timing of decompression and clinical outcome. One hundred four citations were reviewed, and 42 met the inclusion criteria. Preoperative and postoperative data were recorded. Length of time to surgery was broken down into five groups: less than 24 hours, 24-48 hours, 2-10 days, 11 days to 1 month, and more than 1 month. Logistic regression was used to determine the association between preoperative variables and postoperative outcomes. RESULTS:Outcomes were analyzed in 322 patients. Preoperative chronic back pain was associated with poorer outcomes in urinary and rectal function, and preoperative rectal dysfunction was associated with worsened outcome in urinary continence. In addition, increasing age was associated with poorer postoperative sexual function. No significant improvement in surgical outcome was identified with intervention less than 24 hours from the onset of cauda equina syndrome compared with patients treated within 24-48 hours. Similarly, no difference in outcome occurred in patients treated more than 48 hours after the onset of symptoms. Significant differences, however, were found in resolution of sensory and motor deficits as well as urinary and rectal function in patients treated within 48 hours compared with those treated more than 48 hours after onset of symptoms. CONCLUSIONS:There was a significant advantage to treating patients within 48 hours versus more than 48 hours after the onset of cauda equina syndrome. A significant improvement in sensory and motor deficits as well as urinary and rectal function occurred in patients who underwent decompression within 48 hours versus after 48 hours.

journal_name

Spine (Phila Pa 1976)

journal_title

Spine

authors

Ahn UM,Ahn NU,Buchowski JM,Garrett ES,Sieber AN,Kostuik JP

doi

10.1097/00007632-200006150-00010

keywords:

subject

Has Abstract

pub_date

2000-06-15 00:00:00

pages

1515-22

issue

eissn

0362-2436

issn

1528-1159

journal_volume

pub_type

杂志文章,meta分析

在线工具

Cauda equina syndrome secondary to lumbar disc herniation: a meta-analysis of surgical outcomes.