Lumbar decompression surgery for cauda equina syndrome — comparison of complication rates between daytime and overnight operating

Francis, Jibin; Goacher, Edward; Fuge, Joshua; Hanrahan, John; Zhang, James; Davies, B. I.; Trivedi, Rikin; Laing, Rodney

doi:10.1007/s00701-022-05173-2

Cited by 3 publications

(3 citation statements)

References 30 publications

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“…Other studies that did not define timing from symptoms, used equally heterogenous definitions such as hospital admission, presentation to first doctor and radiological confirmation. These checkpoints vary considerably depending on characteristics of the healthcare system and the underlying aetiology of CES [ 22 ]. A major limitation among reporting time to surgery arises from the design of these studies being included.…”

Section: Discussionmentioning

confidence: 99%

“…Another aspect of CES surgery which is less commonly explored is the time of surgery. Only two studies in the literature report on outcomes relating to the time of surgery [ 21 , 22 ]. Both are single centre retrospective studies conducted in the United Kingdom and report higher rates of intra-operative complications for decompression surgeries carried out overnight.…”

Section: Discussionmentioning

confidence: 99%

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Definition and surgical timing in cauda equina syndrome–An updated systematic review

et al. 2023

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Study design Systematic review. Objectives To conduct a systematic review identifying existing definitions of cauda equina syndrome (CES) and time to surgery in the literature for patients with CES. Methods A systematic review was conducted in accordance with the PRISMA statement. Ovid Medline, Embase, CINAHL Plus, and trial registries were searched from October 1st, 2016, to 30th December 2022, and combined with articles identified from a previous systematic review by the same authors (studies published 1990–2016). Results A total of 110 studies (52,008 patients) were included. Of these only 16 (14.5%) used established definitions in defining CES, including Fraser criteria (n = 6), British Association of Spine Surgeons (BASS) (n = 5), Gleave and MacFarlane (n = 2), and other (n = 3). Most reported symptoms were urinary dysfunction (n = 44, 40%%), altered sensation in the perianal region (n = 28, 25.5%) and bowel dysfunction (n = 20, 18.2%). Sixty-eight (61.8%) studies included details on time to surgery. There was an increase in percentage of studies defining CES published in the last 5 years compared to ones from 1990–2016 (58.6% vs 77.5.%, P = .045). Conclusions Despite Fraser recommendations, substantial heterogeneity exists in reporting of CES definitions, and a start point for time to surgery, with most authors using self-defined criteria. A consensus is required to define CES and time to surgery, to allow consistency in reporting and study analysis.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Definition and surgical timing in cauda equina syndrome–An updated systematic review

et al. 2023

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“…The most common complication identified in our study was an ED visit within 30 days. Age, current smoking status, longer hospital length of stay, and history of renal failure have been previously associated with complications after lumbar decompression surgery in one single institution study [ 31 ]. Jain et al.…”

Section: Discussionmentioning

confidence: 99%

The Reoperation, Readmission, and Complication Rates at 30 Days Following Lumbar Decompression for Cauda Equina Syndrome

Filler,

Nayak,

Razzouk

et al. 2023

Cureus

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Background and objective Cauda equina syndrome (CES) is considered a surgical emergency, and its primary treatment involves decompression of the nerve roots, typically in the form of discectomy or laminectomy. The primary aim of this study was to determine the complication, reoperation, and readmission rates within 30 days of surgical treatment of CES secondary to disc herniation by using the PearlDiver database (PearlDiver Technologies, Colorado Springs, CO). The secondary aim was to assess preoperative risk factors for a higher likelihood of complication occurrence within 30 days of surgery for CES. Methods A total of 524 patients who had undergone lumbar discectomy or laminectomy for CES were identified. The outcome measures were 30-day reoperation rate for revision decompression or lumbar fusion, and 30-day readmissions related to surgery. The patient data collected included medical history and surgical data including the number of levels of discectomy and laminectomy. Results Based on our findings, intraoperative dural tears, valvular heart disease, and fluid and electrolyte abnormalities were significant risk factors for readmission to the hospital within 30 days following surgery for CES. The most common postoperative complications were as follows: visits to the emergency department (63 patients, 12%), surgical site infection (21 patients, 4%), urinary tract infection (14 patients, 3%), and postoperative anemia (11 patients, 2%). Conclusions In the 30-day period following lumbar decompression for cauda equina syndrome, our findings demonstrated an 8% reoperation rate and 17% readmission rate. Although CES is considered an indication for urgent surgery, gaining awareness about reoperation, readmission, and complication rates in the immediate postoperative period may help calibrate expectations and inform medical decision-making.

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Cauda equina syndrome — from timely treatment to the timing of out–of-hours surgery

Demetriades

2022

Acta Neurochir

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Lumbar decompression surgery for cauda equina syndrome — comparison of complication rates between daytime and overnight operating

Cited by 3 publications

References 30 publications

Definition and surgical timing in cauda equina syndrome–An updated systematic review

Definition and surgical timing in cauda equina syndrome–An updated systematic review

The Reoperation, Readmission, and Complication Rates at 30 Days Following Lumbar Decompression for Cauda Equina Syndrome

Cauda equina syndrome — from timely treatment to the timing of out–of-hours surgery

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