AI Article Synopsis
- A systematic review was conducted to identify definitions of cauda equina syndrome (CES) and analyze the time to surgery for patients diagnosed with CES from literature dating back to 1990.
- Out of 110 studies involving over 52,000 patients, only 14.5% adhered to established definitions for CES, with urinary dysfunction being the most reported symptom.
- The findings highlight a growing trend in definition consistency over the past five years but stress the need for a standardized definition and guidelines for reporting and analyzing surgery timing to improve clarity in future research.
Article Abstract
Study Design: Systematic review.
Objectives: To conduct a systematic review identifying existing definitions of cauda equina syndrome (CES) and time to surgery in the literature for patients with CES.
Methods: A systematic review was conducted in accordance with the PRISMA statement. Ovid Medline, Embase, CINAHL Plus, and trial registries were searched from October 1st, 2016, to 30th December 2022, and combined with articles identified from a previous systematic review by the same authors (studies published 1990-2016).
Results: A total of 110 studies (52,008 patients) were included. Of these only 16 (14.5%) used established definitions in defining CES, including Fraser criteria (n = 6), British Association of Spine Surgeons (BASS) (n = 5), Gleave and MacFarlane (n = 2), and other (n = 3). Most reported symptoms were urinary dysfunction (n = 44, 40%%), altered sensation in the perianal region (n = 28, 25.5%) and bowel dysfunction (n = 20, 18.2%). Sixty-eight (61.8%) studies included details on time to surgery. There was an increase in percentage of studies defining CES published in the last 5 years compared to ones from 1990-2016 (58.6% vs 77.5.%, P = .045).
Conclusions: Despite Fraser recommendations, substantial heterogeneity exists in reporting of CES definitions, and a start point for time to surgery, with most authors using self-defined criteria. A consensus is required to define CES and time to surgery, to allow consistency in reporting and study analysis.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC10159340 | PMC |
| http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0285006 | PLOS |
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