Is cauda equina syndrome linked with obesity?

Area of Science:

• Neurosurgery
• Orthopedics
• Epidemiology

Background:

• Cauda equina syndrome (CES) is a surgical emergency requiring prompt diagnosis and treatment.
• The physical characteristics of patients predisposed to CES remain under-investigated.
• Understanding patient demographics may aid in risk stratification and early identification of CES.

Purpose of the Study:

• To compare the anthropometric features of patients with CES to those undergoing elective lumbar surgery.
• To identify physical characteristics associated with an increased risk of developing CES.
• To investigate the relationship between body mass index (BMI) and the severity of disc prolapse in CES patients.

Main Methods:

• Retrospective comparison of anthropometric data (age, gender, height, weight, BMI) between CES patients and elective surgery patients.
• Univariate and multivariate logistic regression analyses were performed to assess risk factors for CES.
• Body mass index (BMI) was categorized according to World Health Organization (WHO) criteria.

Main Results:

• Patients with CES exhibited significantly higher mean BMI (31.1 kg/m2) and weight compared to the elective surgery group (26.5 kg/m2) and national averages.
• Increased BMI (OR 1.17) and weight (OR 1.06) were strongly associated with a higher risk of CES.
• Overweight and obese individuals (BMI ≥ 25 kg/m2) had a 3.7 times higher odds of developing CES.
• Larger disc prolapses obstructing the spinal canal were associated with higher BMI in CES patients.

Conclusions:

• Elevated body mass index (BMI) is a significant risk factor for developing cauda equina syndrome (CES).
• Higher weight and obesity increase the likelihood of CES, while greater height may be protective.
• These findings suggest that weight management could play a role in mitigating CES risk.