Br J Neurosurg
Department of Clinical Neurosciences, The University of Edinburgh, Western General Hospital, Edinburgh, UK.
Published: February 2020
Background The clinical symptoms and signs of Cauda equina syndrome (CES) are non specific and poorly predictive of cauda equina compression on MRI. We aimed to establish whether a history of lumbar spine surgery predicts cauda equina compression on MRI in those presenting with suspected CES. A retrospective electronic record review was undertaken of 276 patients referred with clinically suspected CES who underwent a lumbosacral spine MRI. Those with a history of prior lumbar surgery were compared to those without. The likelihood of cauda equina compression was compared between the two groups. About 78/276 (28%) patients with suspected CES had radiological compression of the cauda equina and went on to surgical decompression. A total of 54 (20%) patients had undergone prior lumbar surgery. Patients with a history of lumbar surgery were less likely to have cauda equina compression on MRI ( - = .035). Twenty six (9%) patients presented more than once with suspected CES. Patients with a history of lumbar surgery were more likely to re-present with suspected CES ( - = .002). Prior lumbar surgery was associated with a higher frequency of re-presentation with clinically suspected CES but a lower frequency of radiological cauda equina compression.
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http://dx.doi.org/10.1080/02688697.2019.1687845 | DOI Listing |
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