BACKGROUND
Cauda equina syndrome is a relatively rare presenting symptom of lumbar her
niated discs. Early operative decompression is advocated, but it may not al
ways restore the bladder function. In such cases, knowing the long-term out
come of bladder or sphincter disturbances is quite useful in planning the m
anagement of these patients.
METHODS
Hospital records of patients operated on for lumbar herniated discs were re
viewed. Charts and imaging studies of those patients who presented with cla
ssic cauda equina syndrome were analyzed.
RESULTS
There were 4 patients (2.8%) of 144 consecutive surgical series of lumbar d
isc herniation, whose presenting symptom was classic cauda equina syndrome.
Postoperatively, the patients had been followed at the clinic for a mean p
eriod of 6.4 years. Certain characteristic findings were noted on patients'
neurological and radiological examinations. Although the recovery process
of bladder function was very slow, taking months to years, all four patient
s achieved almost normal voiding with no major impairment of daily activiti
es.
CONCLUSIONS
Even if short-term recovery of bladder function is poor after lumbar disc s
urgery for cauda equina syndrome, the long-term outcome is not necessarily
so. We should follow up on these patients with such measures as intermitten
t self-catheterization and drug therapy, expecting slow but steady recovery
of bladder and sphincter function. (C) 2000 by Elsevier Science Inc.