Irkutsk State Medical University, Irkutsk, Russia.
Russian Railways-Medicine Clinical Hospital, Irkutsk, Russia.
Zh Vopr Neirokhir Im N N Burdenko. 2023;87(1):35-43. doi: 10.17116/neiro20238701135.
Cauda equina syndrome (CES) associated with acute disc extrusion or spinal stenosis often requires emergency surgery. Analysis of the Pubmed, Medline and eLibrary databases revealed a few studies devoted to long-term postoperative outcomes in patients with CES caused by degenerative spine disease.
To evaluate long-term postoperative results and predictors of clinical and neurological outcomes in patients with CES caused by degenerative lumbar spine disease.
MATERIAL AND METHODS. D: Ecompressive and decompressive-stabilizing procedures were performed in 211 patients with CES caused by degenerative lumbar spine disease between 2000 and 2020. Long-term clinical parameters were available in 174 patients with mean follow-up period of 7 years. Sixty-eight patients had unsatisfactory postoperative outcomes. We assessed postoperative clinical and neurological outcomes in patients with CES and predictors of these outcomes.
We identified the following predictors of clinical and neurological outcomes using binary logistic regression model: period between clinical manifestation and surgery >48 hours, preoperative neurological impairment, spinal canal diameter, surgical procedure, dimension of herniated disc, ASA score and long-term postoperative analgesia with narcotic analgesics.
Preoperative planning and possible correction of the above-mentioned risk factors will potentially improve postoperative outcomes in patients with CES caused by degenerative lumbar spine disease.
评估由退行性腰椎疾病引起的马尾综合征（CES）患者的长期手术治疗效果及预测临床和神经功能结局的因素。
2000 年至 2020 年，对 211 例由退行性腰椎疾病引起 CES 的患者施行减压或减压固定术。术后随访 7 年以上的患者有 174 例，其中 68 例患者的术后效果不满意。我们评估了 CES 患者的术后临床和神经功能结局及其影响因素。
应用二元逻辑回归模型确定了以下与临床和神经功能结局相关的预测因素：症状出现至手术的时间>48 小时、术前神经功能损伤、椎管直径、手术方式、椎间盘突出的大小、ASA 评分以及术后长期使用阿片类药物进行镇痛。
术前计划和可能纠正上述危险因素可能会提高由退行性腰椎疾病引起的 CES 患者的术后治疗效果。
