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KMID : 0388720110180020057
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Journal of Korean Society of Spine Surgery
2011 Volume.18 No. 2 p.57 ~ p.63
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Clinical Outcome Based Cauda Equina Syndrome Scoring System for Prediction of Prognosis
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Yang Jun-Young
Lee June-Kyu
Song Ho-Sup
Joo Yong-Bum
Cha Soo-Min
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Abstract
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Study Design: This is a retrospective study.
Objectives: We made a scoring system using the symptoms of cauda equina syndrome(CES) and we studied the efficacy of the scoring system.
Summary of Literature Review: There has been no definite scoring system with clear factors that can predict the clinical results of cauda equine syndrome.
Materials and Methods: Between 1998 and 2006, 21 patients who were diagnosed with CES and who were followed for more than 2 years were enrolled in this study. There were 6 cases of HIVD, 6 cases of degenerative spondylosis, 7 cases of vertebral fracture and 2 cases of metastatic spinal tumor. We made a scoring system for CES (SSCES) using 8 symptoms among the general clinical manifestations that accompany CES, which are low back pain, sciatic neuropathy, sensory and motor disorder of the lower extremities, loss of a saddle sensation, voiding difficulty, disorder of the anal sphincter tone and deep tendon reflex disorder.
Results: The last clinical outcomes were 3 excellent patients, 5 good patients, 5 fair patients and 8 poor patients. The mean preoperative SSCES was 11.7±2.8(7-16) and the mean final follow up score was 7.6±3.4(2-13). Eight cases that had a mean preoperative SSCES score of 6 or below showed good clinical results with a mean SSCES of 3.9±11(2-5) on the final follow up, and 13 cases with a mean preoperative SSCES score of 7 or above showed bad clinical results with a mean SSCES of 9.9±1.9(7-13) on the final follow up.
Conclusions: The prognosis was better on the final follow up for the patients with a lowere preoperative SSCES. So, for the treatment of CES, preoperative evaluation using the SSCES is thought to be very useful for predicting the prognosis.
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KEYWORD
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Cauda equina syndrome, Prognostic factor, Scoring system
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