CAUDA EQUINA SYNDROME: FACTORS AFFECTING THE OUTCOME OF 42 PATIENTS WITH A MEAN FOLLOW UP OF 5 YEARS

Objective: To determine the factors which influence outcome after surgery for cauda equina syndrome. Particular attention has been given to sphincteric recovery. Study Design: Retrospective cohort study with prospective clinical follow up. Subjects: 56 patients with evidence of a sphincteric disturbance who underwent urgent surgery between 1994 and 2002 were identified and invited for follow up. Outcome Measures: History and examination, Oswestry Disability Index, Short Form 36 Health Survey Questionnaire, Visual Analogue Score, Low Back Outcome Score, Modified Somatic Perception Score, Modified Zung Depression Score, International Prostate Severity Score, Male Sexual Health Questionnaire and Sheffield Female Pelvic Floor Questionnaire. Results: 42 patients attended with a mean follow up of 60 months (Range 25–114 months). Mean age at onset was 41 years (Range 24–67 years) with 23 males and 19 females. 25 patients had sudden onset of symptoms in less than 24 hours. 26 patients were operated on within 48 hours of onset. At presentation urinary retention was associated with acute onset of less than 24 hours (p At follow up significantly more females had urinary incontinence (p Conclusions: In our series the duration of symptoms and speed of onset prior to surgery appears to influence bowel but not bladder outcome two years after surgery. Based on the SF36, LBOS and ODI scores, patients who have had CES do not return to a normal status. Patient counselling about this would therefore be appropriate.