Improvement in Neurogenic Bowel and Bladder Dysfunction Following Posterior Decompression Surgery for Cauda Equina...

Area of Science:

• Neurology
• Urology
• Spinal Surgery

Background:

• Neurogenic bowel dysfunction (NBD) and neurogenic bladder (NB) are significant complications of spinal cord injury and degenerative lumbar diseases.
• Cauda equina syndrome frequently leads to NBD and NB, impacting patient quality of life.

Purpose of the Study:

• To investigate the prevalence of NBD and NB in cauda equina syndrome patients before surgery.
• To assess the degree and timing of symptom improvement following posterior decompression surgery for NBD and NB.

Main Methods:

• Utilized the Constipation Scoring System (CSS) and International Prostate Symptoms Score (IPSS) to evaluate NBD and NB.
• Administered CSS and IPSS to 93 patients preoperatively and at 1, 3, 6, and 12 months postoperatively.
• Prospectively analyzed patient characteristics, Japanese Orthopaedic Association (JOA) scores, and symptom improvements.

Main Results:

• Preoperative prevalence of symptomatic defecation and urinary issues was 38.1% and 33.3%, respectively.
• Postoperative improvement in defecation symptoms was noted in 30%-50% of patients within 1 year.
• Urinary symptom improvement was observed in 30%-50% of patients within 1 year, with JOA score improvement being a significant prognostic factor.

Conclusions:

• Posterior decompression surgery effectively improves NBD and NB symptoms in cauda equina syndrome patients.
• Symptom improvement is evident as early as 1 month post-surgery and persists for up to 12 months.
• The degree of JOA score improvement is a key predictor of positive outcomes for defecation problems.