Cauda Equina Syndrome Retention Type –Late Intervention Can also give Excellent Results

Abstract

Introduction: Cauda Equina Syndrome (CES) is an acute stenosis of lumbar spinal canal leading to compression of neural elements below the level of L1 mostly due to disc herniation but other causes exist. Intervention within 48 hours prevent permanent sensorimotor, sphincter and sexual disturbances. We reporttwelvecases of Cauda Equina Syndrome with complete sensorimotor deficit, bladder, bowel dysfunction intervened at least 1 month after initiation of symptoms with complete recovery of functions. Till date a few literature support is there to substantiate this evidence. Methods: 22 patients between 2011 to 2015, 18 male and 4 female, attended with complete or retention type of cauda equina syndrome. Of the 8 men, 5 had acute discherniations, 2 had caries spine, 1 had trauma. Of the 4 women,3 had acute disc herniation,1 had caries spine. 4 attended 35- 39 days, 4 between 45- 45 days,4 between 45- 60 days. They were urgently decompressed within 72 hours of attendance. 4 were lost in follow- up within 1 year. Rest were followed up3- 5 years. Results: 3 patients improved by 14 to 28 days, their neurological status improved from ASIA A to ASIA D, 4 patients by 30 to 90 days from ASIA A to ASIA E. 1 male patient improved from ASIA A to ASIA C in 3 years. All the above neurological status maintained. 2 men and 2 women were lost to follow up within 1 year when their improvement were by only one grade in ASIA impairment scale. 7 out of 8 patients had excellent results. Conclusion: Though early intervention is the golden rule, in late presentations of complete cauda equine syndrome, thorough decompression improves the neurological status of the patient