Neurosurgery for Cauda Equina Syndrome

Neurosurgery for Cauda Equina Syndrome

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In the United States, approximately 1-3% of patients who undergo spinal surgery for cauda equina syndrome (CES) have either atraumatic or traumatic types of CES. [1] CES has no predilection for any race or either sex. Although CES can occur at any age, it is most often seen in adults in whom the spinal canal may already be compromised and stenosed.

The prognosis for CES improves if a definitive cause is identified and management is instituted early. Surgical treatment may be necessary for decompression or tumor removal, especially if the patient presents with acute onset of symptoms. Surgical decompression should be performed if the patient is medically stable and able to undergo the procedure. [2, 3, 4, 5]

In acute compression of the conus medullaris or cauda equina, surgical decompression as soon as possible becomes mandatory. In a more chronic presentation with less severe symptoms, decompression could be performed when medically feasible and should be delayed to optimize the patient’s medical condition; with this precaution, decompression is less likely to lead to irreversible neurologic damage.

Images depicting cauda equina syndrome can be seen below.

Go to Cauda Equina and Conus Medullaris Syndromes and Tumors of the Conus and Cauda Equina for complete information on these topics.

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Nazer H Qureshi, MD Neurosurgeon, Princeton Brain and Spine

Nazer H Qureshi, MD is a member of the following medical societies: American Association of Neurological Surgeons, American College of Surgeons, Congress of Neurological Surgeons, World Society for Stereotactic and Functional Neurosurgery

Disclosure: Nothing to disclose.

T Glenn Pait, MD, FACS Professor, Department of Neurosurgery, Department of Orthopedic Surgery, Jackson T Stephens Chair, Spine Surgery, University of Arkansas for Medical Sciences College of Medicine; Director, Jackson T Stephens Spine and Neurosciences Institute

T Glenn Pait, MD, FACS is a member of the following medical societies: American Association of Neurological Surgeons, American Medical Association, Arkansas Medical Society, North American Skull Base Society, North American Spine Society, West Virginia State Medical Association, Congress of Neurological Surgeons

Disclosure: Nothing to disclose.

Emad Fahmi Soliman, MD, MSc Consulting Staff, Department of Neurology, St John’s Riverside Hospital

Emad Fahmi Soliman, MD, MSc is a member of the following medical societies: American Academy of Neurology, American Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Ryszard M Pluta, MD, PhD Associate Professor, Neurosurgical Department Medical Research Center, Polish Academy of Sciences, Poland; Clinical Staff Scientist, Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke, National Institutes of Health (NIH); Fishbein Fellow, JAMA

Ryszard M Pluta, MD, PhD is a member of the following medical societies: Polish Society of Neurosurgeons, Congress of Neurological Surgeons

Disclosure: Nothing to disclose.

Brian H Kopell, MD Associate Professor, Department of Neurosurgery, Icahn School of Medicine at Mount Sinai

Brian H Kopell, MD is a member of the following medical societies: Alpha Omega Alpha, American Association of Neurological Surgeons, American Society for Stereotactic and Functional Neurosurgery, Congress of Neurological Surgeons, International Parkinson and Movement Disorder Society, North American Neuromodulation Society

Disclosure: Received consulting fee from Medtronic for consulting; Received consulting fee from Abbott Neuromodulation for consulting.

Duc Hoang Duong, MD Professor, Chief Physician, Departments of Neurological Surgery and Neuroscience, Epilepsy Center, Charles Drew University of Medicine and Science

Duc Hoang Duong, MD is a member of the following medical societies: American Neurological Association, Congress of Neurological Surgeons, North American Skull Base Society

Disclosure: Nothing to disclose.

Neurosurgery for Cauda Equina Syndrome

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