ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2026
The impact of prolapse to canal ratio (PCR) in cauda equina syndrome outcomes and operative management.
Article in 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, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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Who cites it
2 citing papers in PubMed.
- Dural Sac Cross-Sectional Area Measurement as an Indicator of Cauda Equina Syndrome Risk in Patients with Lumbar Disc Herniation.Journal of clinical medicine · 2026Article
- Acute Cauda Equina Syndrome With Clinicoradiological Discordance Treated via Unilateral Biportal Endoscopy: A Case Report.Case reports in neurological medicine · 2026Article
Corrections and comments
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Authors and funding
14 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study aimed to evaluate the prolapse to canal ratio (PCR) and its long-term impact on outcomes in cauda equina syndrome (CES).
methodsA 5-year retrospective cohort study was conducted across two neurosurgical centers, including adult patients diagnosed with CES due to herniated lumbar discs, treated with laminectomy and/or discectomy, with available radiological data and follow-up. PCR was calculated as the proportion of the disc prolapse cross-sectional area to the total spinal canal area. MRI scans were independently analyzed by two investigators, with random verification by a third. Patient demographics, symptoms, treatment, and follow-up data were also collected.
resultsAmong 137 patients, cohorts were divided using a PCR cut-off of 0.5. Patients with PCR > 0.5 were significantly more likely to have persistent symptoms at follow-up (OR 3.93, CI 2.25-7.34, p < 0.0001). This risk increased with higher PCR thresholds (> 0.75 and > 0.8). PCR > 0.5 also predicted a greater likelihood of requiring a full laminectomy over minimally invasive approaches (OR 2.14, 95% CI 1.3-3.6, p < 0.005). Lower PCR (< 0.5) was associated with reduced complication rates and shorter hospital stays.
conclusionsPCR is a valuable predictor of persistent pain and functional deficits following CES surgery and could be used to guide patient counseling before surgical intervention.
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