Subject(s)
Humans , Female , Adult , Polyradiculopathy/surgery , Polyradiculopathy/etiology , Polyradiculopathy/diagnostic imaging , Spinal Cord Neoplasms/surgery , Spinal Cord Neoplasms/complications , Spinal Cord Neoplasms/diagnostic imaging , Lipoma/surgery , Lipoma/complications , Lipoma/diagnostic imaging , Magnetic Resonance ImagingABSTRACT
Objetivo: O objetivo primário deste estudo é analisar as características e desfechos dos casos internados por síndrome da cauda equina (SCE) em nosso serviço. Secundariamente, este trabalho servirá de base para outros estudos comparativos visando um entendimento maior da doença e de sua epidemiologia. Métodos: estudo retrospectivo dos prontuários das internações por SCE no IOT-HCFMUSP no período de 2005 a 2011 com diagnósticos de SCE e bexiga neuropática. As seguintes variáveis foram analisadas: sexo, idade, etiologia da doença, nível topográfico da lesão, tempo de história da lesão até o diagnóstico, presença de bexiga neurogênica, tempo entre o diagnóstico da SCE e a cirurgia, reversão do déficit ou da bexiga neurogênica. Resultados: por tratar-se de uma doença rara, não conseguimos estabelecer correlações estatisticamente significativas entre as variáveis analisadas e os desfechos da doença. Porém, este estudo evidenciou deficiências do nosso sistema público de saúde quanto ao manejo desses pacientes. Conclusão: o trabalho mostra que apesar de bem definidas as bases para conduta da SCE, observamos um número maior de sequelas causadas pela patologia, do que visto na literatura. O atraso no diagnóstico e, a partir deste, do tratamento definitivo, foi a causa para o alto número de sequelas. Nível de evidência IV, Série de Casos.
Objective: The primary purpose of this study was to determinate the characteristics and outcomes of the patients admitted at our clinics diagnosed with cauda equina syndrome (CES). Secondarily, this study will serve as a basis for other comparative studies aiming the better understanding of this condition and its epidemiology. Methods: we conducted a retrospective study by reviewing the medical records of patients diagnosed with CES and neurogenic bladder between 2005 and 2011. The following variables were analyzed: gender, age, etiology, topographic level of the lesion, time between disease onset and diagnosis, presence of neurogenic bladder, time between diagnosis and surgery, neurological damage and neurogenic bladder persistence. Results: considering that CES is a rare condition, we were not able to establish statistic correlation between the analyzed variables and the outcomes of the disease. However, this study brought to light the inadequacy of our public health system in treating that kind of patient. Conclusion: The study shows that despite the well-defined basis for managing CES, we noted a greater number of patients with sequels caused by this condition, than it is seen in the literature. The delayed diagnosis and, consequently, delayed treatment, were the main causes for the results observed. Level of Evidence IV, Case Series.
Subject(s)
Humans , Male , Female , Intervertebral Disc Displacement , Polyradiculopathy/surgery , Polyradiculopathy/complications , Polyradiculopathy/epidemiology , Urinary Bladder, Neurogenic , Magnetic Resonance Spectroscopy , Medical Records , Statistics on Sequelae and DisabilityABSTRACT
Cauda equina syndrome is secondary to lumbo sacral nerve roots compression, it is a rare complication of a lumbar disc herniation. Earlier surgical treatment has to be performed for a best improvement. We report 24 cases of cauda equina syndrome secondary to a disc herniation. 58% of our patients were males and the mean age was 47.7 years. Clinical examination found genito sphincteriens disturbances [80%], strenght deficits [62.5%], and sensitif troubles [84%]. CT scan and MRI confirmed the cauda equina compression by a disc herniation, wich were more frequent at L4L5 level [83%]. Surgical treatment was performed in all our cases: laminectomy and discectomy. Clinical out come was satisfactory in 83.5% of cases