Farid Yudoyono, Arief Setia Handoko, Adhitya Rahadi Yudhadi, Hadian Adhipratama, Hasan Baraqbah
Background: Conus medullaris syndrome (CMS) and cauda equina syndrome (CES) are complex neurological disorders with varying symptoms. Patients often complain of weakness in both legs, walking problems, numbness in the legs, bowel movements, and urination problems. The causes also vary, such as trauma, tumors, infections, and degenerative processes. This study aimed to evaluate the clinical outcome in patients with CMS and CES after surgical procedures.
Methods: We included 37 subjects with CMS/CES treated with decompression with posterior stabilization surgery. A detailed visual analog scale (VAS) score of Low Back Pain (LBP) and Oswestry Disability Index (ODI) were used to quantify the clinical improvement at the final follow-up.
Results: Thirty-seven subjects enrolled in this study. VAS scores before surgery at six months and nine months were 7.62 ± 0.6, 3.16 ± 0.7, and 2.67 ± 0.5, respectively. ODI from baseline, six months, and nine months were 49.73 ± 10, 28.11 ± 6.51, and 12.6 ± 6.65 which demonstrated significant improvement in VAS and ODI scores (p < 0.001). The Mc-Nab criteria was excellent in 8.1%, good in 72.9%, fair in 5.49%, and poor in 13.5% of subjects. No complication was found after surgery.
Conclusion: Decompression and stabilization surgery may reduce pain and disability, and improve clinical outcomes. Bowel and bladder dysfunction were still felt during six months of postoperative follow-up. A complete preoperative assessment and surgery in a timely manner according to the course of the neurological deficit can prevent the disease from progressing to a chronic condition.
Keywords: cauda equina syndrome; clinical outcome; conus medullaris syndrome