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Clinical Outcome Based Cauda Equina Syndrome Scoring System for Prediction of Prognosis

  • Journal of Korean Society of Spine Surgery
  • Abbr : J Kor Spine Sur
  • 2011, 18(2), pp.57-63
  • Publisher : Korean Society Of Spine Surgery
  • Research Area : Medicine and Pharmacy > Orthopedic Surgery

양준영 1 이준규 1 송호섭 1 주용범 1 차수민 1

1충남대학교

Accredited

ABSTRACT

Study Design: This is a retrospective study Objectives: We made a scoring system using the symptoms of cauda equina syndrome(CES) and we studied the efficacy of the scoring system. Summary of the Literature Review: There has been no definite scoring system with clear factors that can predict the clinical results of cauda equine syndrome Materials and Methods: Between 1998 and 2006, 21 patients who were diagnosed with CES and who were followed for more than 2 years were enrolled in this study. There were 6 cases of HIVD, 6 cases of degenerative spondylosis, 7 cases of vertebral fracture and 2 cases of metastatic spinal tumor. We made a scoring system for CES (SSCES) using 8 symptoms among the general clinical manifestations that accompany CES, which are low back pain, sciatic neuropathy, sensory and motor disorder of the lower extremities,loss of a saddle sensation, voiding difficulty, disorder of the anal sphincter tone and deep tendon reflex disorder. Results: The last clinical outcomes were 3 excellent patients, 5 good patients, 5 fair patients and 8 poor patients. The mean preoperative SSCES was 11.7±2.8(7-16) and the mean final follow up score was 7.6±3.4(2-13). Eight cases that had a mean preoperative SSCES score of 6 or below showed good clinical results with a mean SSCES of 3.9±11(2-5) on the final follow up, and 13 cases with a mean preoperative SSCES score of 7 or above showed bad clinical results with a mean SSCES of 9.9±1.9(7-13) on the final follow up. Conclusions: The prognosis was better on the final follow up for the patients with a lowere preoperative SSCES. So, for the treatment of CES, preoperative evaluation using the SSCES is thought to be very useful for predicting the prognosis. Key Words: Cauda equina syndrome, Prognostic factor, Scoring system

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