European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society
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Review Meta Analysis
Outcomes of cauda equina syndrome due to lumbar disc herniation after surgical management and the factors affecting it: a systematic review and meta-analysis of 22 studies with 852 cases.
This study aimed to investigate the long-term clinical outcomes after surgical decompression in cauda equina syndrome (CES) and see if any preoperative patient-related factors contributed to this outcome. ⋯ The long-term outcomes of CES after decompression are enumerated. Decompression within 48 hours of the onset of symptoms appears to result in fewer patients with persistent bladder dysfunction. However, a randomized controlled trial is required to conclusively determine whether early decompression leads to better outcomes.
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Review Meta Analysis
Outcomes of cauda equina syndrome due to lumbar disc herniation after surgical management and the factors affecting it: a systematic review and meta-analysis of 22 studies with 852 cases.
This study aimed to investigate the long-term clinical outcomes after surgical decompression in cauda equina syndrome (CES) and see if any preoperative patient-related factors contributed to this outcome. ⋯ The long-term outcomes of CES after decompression are enumerated. Decompression within 48 hours of the onset of symptoms appears to result in fewer patients with persistent bladder dysfunction. However, a randomized controlled trial is required to conclusively determine whether early decompression leads to better outcomes.
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Unlike tandem stenosis of the cervical and lumbar spine, tandem cervical and thoracic stenosis (TCTS) of the spine is less common, and the approach and order of intervention are controversial. We aim to review the literature to evaluate the incidence and interventions for patients with cervical and thoracic stenosis. We provide illustrative cases to demonstrate that thoracic myelopathy in the setting of asymptomatic cervical stenosis can be treated safely. ⋯ In patients presenting with myelopathy, both cervical and thoracic spine should be evaluated for TCTS. Order of operative intervention is tailored to clinical and radiographic information. In cases of thoracic myelopathy with asymptomatic cervical stenosis, thoracic intervention can be pursued with precautions to prevent further cervical cord injury.
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Unlike tandem stenosis of the cervical and lumbar spine, tandem cervical and thoracic stenosis (TCTS) of the spine is less common, and the approach and order of intervention are controversial. We aim to review the literature to evaluate the incidence and interventions for patients with cervical and thoracic stenosis. We provide illustrative cases to demonstrate that thoracic myelopathy in the setting of asymptomatic cervical stenosis can be treated safely. ⋯ In patients presenting with myelopathy, both cervical and thoracic spine should be evaluated for TCTS. Order of operative intervention is tailored to clinical and radiographic information. In cases of thoracic myelopathy with asymptomatic cervical stenosis, thoracic intervention can be pursued with precautions to prevent further cervical cord injury.
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Review Meta Analysis
Conundrum in surgical management of three-column injuries in sub-axial cervical spine: a systematic review and meta-analysis.
Systematic Review and Meta-analysis. ⋯ Diagnostic: individual cross-sectional studies with the consistently applied reference standard and blinding.