Clinical Outcomes of a Novel Capsule Lumbar Interbody Fusion (CLIF) in Delayed Surgical Treatment of Cauda Equina Syndrome Retention (CESR) due to Lumbar Disc Herniation

Abstract

Objective. This present study aimed to explore the clinical effects of a novel capsule lumbar interbody fusion (CLIF) on delayed surgical treatment of cauda equina syndrome retention (CESR) due to lumbar disc herniation. Methods. Between February 2017 and March 2019, a total of 25 patients admitted to our department with delayed surgical treatment (> 48h) of CESR due to lumbar disc herniation were prospectively enrolled. According to the selection of surgical technique, patients were divided into posterior lumbar interbody fusion (PLIF) group and CLIF group. We assessed patients’ neurological status using ODI, recovery rate (RR) of ODI, VAS, ICI-Q-SF, Rintala and IIEF-5 scores. A nerve tension surveying instrument was used to measure the nerve tension before and after intraoperative decompression. Related radiological parameters, operation time, blood loss, surgical segments, and surgery-associated complications were also recorded. Results. All patients acquired improvement of neurological function in various degrees at the final follow-up. However, patients in the CLIF group showed better recovery of ODI and ICI-Q-SF than those in the PLIF group at 6 months after operation and final follow-up (all p < 0.05). In addition, the urodynamics parameters suggested that bladder compliance and residual urine were improved better in the CLIF group at final follow-up (both p < 0.05). Correlation analysis showed that RR of ODI was positively related with change rate of nerve tension at 6 months after operation (r = 0.7171, p < 0.05) and final follow-up (r = 0.540, p < 0.05). No surgery-related complications were observed in both treatment groups. Conclusions. Compared with traditional PLIF surgery, CLIF may more effectively reduce the nerve tension and promote the recovery of nerve function, which is safe and effective for the delayed surgical treatment of CESR.