ArticleJournal of orthopaedics2018
Influence of timing of surgery on Cauda equina syndrome: Outcomes at a national spinal centre.
Article in Journal of orthopaedics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it, 42 citations in OpenAlex.
- Definition and surgical timing in cauda equina syndrome-An updated systematic review.PloS one · 2023Pooled it
- Outcomes of cauda equina syndrome due to lumbar disc herniation after surgical management and the factors affecting it: a systematic review and meta-analysis of 22 studies with 852 cases.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2022Pooled it
- Cauda equina syndrome: a structured approach for the higher orthopaedic examination.European journal of orthopaedic surgery & traumatology : orthopedie traumatologie · 2026Review
- Article
- Is out-of-hours decompression for acute lumbar disc herniation associated with greater peri-operative complications? A tertiary centre, retrospective cohort study.European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society · 2025Article
- The experience and need of patients with cauda equina syndrome caused by lumbar disc herniation: a phenomenological qualitative study.BMC musculoskeletal disorders · 2025Article
- Enhancing Transforaminal Full Endoscopic Discectomy: Efficacy of the Hand Down Outside-In (HDOI) Technique.Journal of personalized medicine · 2024Article
- Cauda equina, conus medullaris and syndromes mimicking sciatic pain: WFNS spine committee recommendations.World neurosurgery: X · 2024Review
- Article
- Surgical timing in traumatic spinal cord injury: current practice and obstacles to early surgery in Latin America.Spinal cord · 2022Article
- Factors affecting urinary outcome after delayed decompression in complete cauda equina syndrome: "A regression model study".European journal of trauma and emergency surgery : official publication of the European Trauma Society · 2022Article
- Review/Perspective: Operations for Cauda Equina Syndromes - "The Sooner the Better".Surgical neurology international · 2022Review
- Article
- Lumbar disc sequestration through the dura into the intrathecal space presenting as acute cauda equina.BMJ case reports · 2021Article
- Out of hours magnetic resonance imaging for suspected cauda equina syndrome: lessons from a comparative study across two centres.Annals of the Royal College of Surgeons of England · 2021Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThere is no doubt that the best outcome achieved in Cauda equina syndrome (CES) involves surgical decompression. The controversy regarding outcome lies with timing of surgery. This study reports outcomes on a large population based series. Timing of surgery, Cauda Equina syndrome classification based on British Association of Spine Surgeons (BASS) guidelines and co-morbid illness will be assessed to evaluate influence on outcome. MATERIALS AND
methodsA retrospective review of all patients surgically decompressed for CES between 01/01/2008 to 01/08/2014 was conducted. Patients with ongoing symptoms were followed up for a minimum of 2 years. Cauda Equina Syndrome (CES) was classified according to the BASS criteria: CES suspicious (CESS), incomplete (CESI) and painless urinary retention (CESR). Time and symptom resolution were assessed.
resultsA total of 136 patients were treated for CES; 69 CESR, 22 CESI and 45 CESS. There was no statistical difference in age, sex, smoking status and alcohol status with regards to timing of surgery. No correlation between increasing co-morbidity score and poor outcome was demonstrated in any subgroupAll CESR/I patients demonstrated some improvement in bowel and bladder dysfunction post-operatively. No significant difference in improved autonomic dysfunction was demonstrated in relation to timing of surgery. CES subclassification may predict outcome of non-autonomic symptoms. Statistically better outcomes were found in CESS groups with regards to post-operative lower back pain (P 0.049) and saddle paraesthesia (P 0.02).
conclusionSurgical Decompression for CES is an effective treatment that significantly improves patient symptoms including bowel and bladder dysfunction Early surgical decompression <24 h from symptom onset does not appear to significantly improve resolution of bowel or bladder dysfunction.
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