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KMID : 0388720230300020078
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Journal of Korean Society of Spine Surgery
2023 Volume.30 No. 2 p.78 ~ p.82
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Bladder and Bowel Dysfunction in Patients with Spinal Compressive Myelopathy
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Choi Byeong-Yeol
Kim Sung-Soo
Lee Ye-Jun
Choi Byung-Wan
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Abstract
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Study Design: Retrospective case analysis Objectives: The purpose of this study was to examine the prevalence and characteristics of bladder and bowel disturbance (BBD) in patients with spinal compressive myelopathy.
Summary of Literature Review: Spinal compressive myelopathy is often associated with BBD. However, few studies have investigated the relationship between neurological evaluation and BBD findings.
Materials and Methods: We evaluated 483 spinal compressive myelopathy patients. Cervical myelopathy was present in 383 cases and thoracic myelopathy in 100 cases. Patients’ mean age was 60.73 years. The mean duration of symptoms was 7.82 months. The clinical characteristics of age, sex, number of involved segments, main symptoms (upper extremity, lower extremity, combined), duration of symptoms, and clinical outcomes were evaluated and compared according to the presence or absence of BBD.
Results: Fifty-six patients had BBD (11%). Bladder dysfunction was present in 32 patients, and bowel dysfunction was observed in 5 patients. Nineteen patients showed both symptoms. There were no significant differences in age (p=0.811), sex (p=0.239), or the number of involved segments (p=0.902) between the BBD and non BBD group. Patients with thoracic myelopathy more frequently exhibited BBD (BBD vs. non BBD: 22 vs. 78) than those with cervical myelopathy (34 vs. 349) (p=0.001). Patients with lower extremity symptoms (20%) and symptoms in both extremities (10%) more frequently showed BBD than those with upper extremity symptoms (2%) (p<0.001).
Conclusions: BBD was more common in patients with thoracic myelopathy and those whose main symptoms were in the lower extremity. Clinical outcomes were better in cervical cases than in thoracic cases.
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KEYWORD
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Compressive myelopathy, neurogenic bladder, bladder bowel dysfunction
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