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Related Experiment Video

Updated: Oct 22, 2025

Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review
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Spinal Hernia Repair and Cauda Equina Repositioning After Lumbar Decompression under Three-Dimensional Microscopy: A Case Report and Literature Review

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Long-term core outcomes in cauda equina syndrome.

Thomas Patrick Barker1,2, Nick Steele1, Girish Swamy1

  • 1Norfolk and Norwich University Hospital, Norwich, UK.

The Bone & Joint Journal
|September 1, 2021
PubMed
Summary

Cauda equina syndrome (CES) frequently causes long-term back pain and autonomic dysfunction, impacting quality of life. This study confirms persistent symptoms in patients years after surgical decompression for CES.

Keywords:
Autonomic dysfunctionCauda equina syndromeCauda equina syndrome (CES)Core outcomesLong-term outcomesLow back painLumbar disc prolapseSpinal Surgeonsback and leg painbladdercatheterdepressionlower back painpatient-reported outcome measuressurgical decompression

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Area of Science:

  • Neurosurgery
  • Orthopedics
  • Spinal Cord Injury

Background:

  • Cauda equina syndrome (CES) presents with severe lower back pain and autonomic dysfunction.
  • The recently defined core outcome set for CES requires assessment in patient cohorts.

Purpose of the Study:

  • To assess the long-term outcomes of patients with CES using validated questionnaires.
  • To evaluate the utility of the CES Core Outcome Set in a clinical cohort.

Main Methods:

  • Retrospective review of 82 patients undergoing surgical decompression for CES (2005-2019).
  • Inclusion criteria: clinical and radiological CES features; classification as CES incomplete (CESI) or CES with painless urinary retention (CESR).
  • Data collection via patient-reported outcome measures (questionnaires).

Main Results:

  • 61 patients completed surveys with a mean follow-up of 58.2 months.
  • High incidence of autonomic dysfunction: 33% bladder, 38% bowel, 53% sexual dysfunction, 47% genital numbness.
  • Significant impact on quality of life: 67% severe back pain, 50% moderate/severe depression, 40% unable to work.

Conclusions:

  • Persistent severe back pain and autonomic dysfunction are common long-term sequelae of CES.
  • Validated patient-reported outcomes confirm the CES Core Outcome Set's relevance.
  • CES significantly impairs quality of life and functional capacity years post-surgery.