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dc.contributor.authorWoodfield, J
dc.contributor.authorHoeritzauer, I
dc.contributor.authorJamjoom, AAB
dc.contributor.authorJung, J
dc.contributor.authorLammy, S
dc.contributor.authorPronin, S
dc.contributor.authorHannan, CJ
dc.contributor.authorWatts, A
dc.contributor.authorHughes, L
dc.contributor.authorMoon, RDC
dc.contributor.authorDarwish, S
dc.contributor.authorRoy, H
dc.contributor.authorCopley, PC
dc.contributor.authorPoon, MTC
dc.contributor.authorThorpe, P
dc.contributor.authorSrikandarajah, N
dc.contributor.authorGrahovac, G
dc.contributor.authorDemetriades, AK
dc.contributor.authorEames, N
dc.contributor.authorSell, PJ
dc.contributor.authorStatham, PFX
dc.contributor.authorAbdelsadg, M
dc.contributor.authorAbulaila, MMS
dc.contributor.authorAhmed, U
dc.contributor.authorAjmi, Q
dc.contributor.authorAl-Mahfoudh, R
dc.contributor.authorAli, C
dc.contributor.authorAmarouche, M
dc.contributor.authorAndalib, A
dc.contributor.authorArora, M
dc.contributor.authorArora, M
dc.contributor.authorAwan, M
dc.contributor.authorBaig Mirza, A
dc.contributor.authorBateman, A
dc.contributor.authorBennett, I
dc.contributor.authorBhatti, I
dc.contributor.authorBodkin, P
dc.contributor.authorBommireddy, L
dc.contributor.authorBonanos, G
dc.contributor.authorBorg, A
dc.contributor.authorBoukas, A
dc.contributor.authorBourne, J
dc.contributor.authorBrennan, R
dc.contributor.authorBrown, J
dc.contributor.authorBrown, K
dc.contributor.authorBurton, O
dc.contributor.authorBusby, C
dc.contributor.authorChiverton, N
dc.contributor.authorClark, S
dc.contributor.authorCopley, PC
dc.contributor.authorCudlip, S
dc.contributor.authorCunningham, Y
dc.contributor.authorDardis, R
dc.contributor.authorDarwish, S
dc.contributor.authorDavies, B
dc.contributor.authorDemetriades, AK
dc.contributor.authorDeore, S
dc.contributor.authorDerham, C
dc.contributor.authorDherijha, M
dc.contributor.authorDobson, G
dc.contributor.authorDuncan, J
dc.contributor.authorDurnford, A
dc.contributor.authorDurst, AZE
dc.contributor.authorDyson, EW
dc.contributor.authorEames, N
dc.contributor.authorEdlmann, E
dc.contributor.authorEdwards-Bailey, A
dc.contributor.authorElserius, A
dc.contributor.authorElson, B
dc.contributor.authorFadelalla, M
dc.contributor.authorFountain, DM
dc.contributor.authorGardner, A
dc.contributor.authorGhosh, A
dc.contributor.authorGill, JR
dc.contributor.authorGlasmacher, SA
dc.contributor.authorGordon, R
dc.contributor.authorGrahovac, G
dc.contributor.authorGrenfell, R
dc.contributor.authorHabeebullah, A
dc.contributor.authorHaliasos, N
dc.contributor.authorHammett, T
dc.contributor.authorHannan, CJ
dc.contributor.authorHill, CS
dc.contributor.authorHoeritzauer, I
dc.contributor.authorHolmes, D
dc.contributor.authorHossain-Ibrahim, K
dc.contributor.authorHughes, L
dc.contributor.authorHussain, M
dc.contributor.authorHussain, S
dc.contributor.authorIbrahim, R
dc.contributor.authorJamjoom, AAB
dc.contributor.authorJohn, B
dc.contributor.authorJoshi, S
dc.contributor.authorJung, J
dc.contributor.authorKennion, O
dc.contributor.authorKhan, M
dc.contributor.authorKlejnotowska, A
dc.contributor.authorKumaria, A
dc.contributor.authorLaCava, R
dc.contributor.authorLammy, S
dc.contributor.authorLawrence, A
dc.contributor.authorLea, M
dc.contributor.authorLeung, AHC
dc.contributor.authorLiew, I
dc.contributor.authorLuo, W
dc.contributor.authorMacCormac, O
dc.contributor.authorManfield, J
dc.contributor.authorMannion, R
dc.contributor.authorMerola, J
dc.contributor.authorMishra, P
dc.contributor.authorMohmoud, KA
dc.contributor.authorMoon, R
dc.contributor.authorMorrison, R
dc.contributor.authorMurray, O
dc.contributor.authorNader-Sepahi, A
dc.contributor.authorNnandi, C
dc.contributor.authorPandit, A
dc.contributor.authorPatel, N
dc.contributor.authorPhilip, A
dc.contributor.authorPoon, MTC
dc.contributor.authorPrasad, KSM
dc.contributor.authorPronin, S
dc.contributor.authorPujara, S
dc.contributor.authorPurushothaman, B
dc.contributor.authorRajwani, K
dc.contributor.authorRasul, FT
dc.contributor.authorRoy, H
dc.contributor.authorSadek, A-R
dc.contributor.authorSchramm, M
dc.contributor.authorScicluna, G
dc.contributor.authorSell, PJ
dc.contributor.authorShafafy, R
dc.contributor.authorSharma, H
dc.contributor.authorSheikh, A
dc.contributor.authorSivasubramaniam, V
dc.contributor.authorSofela, A
dc.contributor.authorSpink, G
dc.contributor.authorSrikandarajah, N
dc.contributor.authorStatham, PFX
dc.contributor.authorStokes, S
dc.contributor.authorStrachan, E
dc.contributor.authorThakar, C
dc.contributor.authorThanabalasundaram, G
dc.contributor.authorThorpe, P
dc.contributor.authorUlbricht, C
dc.contributor.authorWatts, A
dc.contributor.authorWhitcher, A
dc.contributor.authorWhite, D
dc.contributor.authorWhitehouse, K
dc.contributor.authorWilby, M
dc.contributor.authorWoodfield, J
dc.contributor.authorZolnourian, A
dc.date.accessioned2023-02-14T12:37:09Z
dc.date.issued2023-01
dc.identifier.issn2666-7762
dc.identifier.issn2666-7762
dc.identifier.other100545
dc.identifier.urihttp://hdl.handle.net/10026.1/20355
dc.description.abstract

BACKGROUND: Cauda equina syndrome (CES) results from nerve root compression in the lumbosacral spine, usually due to a prolapsed intervertebral disc. Evidence for management of CES is limited by its infrequent occurrence and lack of standardised clinical definitions and outcome measures. METHODS: This is a prospective multi-centre observational cohort study of adults with CES in the UK. We assessed presentation, investigation, management, and all Core Outcome Set domains up to one year post-operatively using clinician and participant reporting. Univariable and multivariable associations with the Oswestry Disability Index (ODI) and urinary outcomes were investigated. FINDINGS: In 621 participants with CES, catheterisation for urinary retention was required pre-operatively in 31% (191/615). At discharge, only 13% (78/616) required a catheter. Median time to surgery from symptom onset was 3 days (IQR:1-8) with 32% (175/545) undergoing surgery within 48 h. Earlier surgery was associated with catheterisation (OR:2.2, 95%CI:1.5-3.3) but not with admission ODI or radiological compression. In multivariable analyses catheter requirement at discharge was associated with pre-operative catheterisation (OR:10.6, 95%CI:5.8-20.4) and one-year ODI was associated with presentation ODI (r = 0.3, 95%CI:0.2-0.4), but neither outcome was associated with time to surgery or radiological compression. Additional healthcare services were required by 65% (320/490) during one year follow up. INTERPRETATION: Post-operative functional improvement occurred even in those presenting with urinary retention. There was no association between outcomes and time to surgery in this observational study. Significant healthcare needs remained post-operatively. FUNDING: DCN Endowment Fund funded study administration. Castor EDC provided database use. No other study funding was received.

dc.format.extent100545-100545
dc.format.mediumElectronic-eCollection
dc.languageen
dc.language.isoeng
dc.publisherElsevier BV
dc.subjectCauda equina syndrome
dc.subjectBack pain
dc.subjectUrinary retention
dc.subjectCohort study
dc.subjectSpinal surgery
dc.titlePresentation, management, and outcomes of cauda equina syndrome up to one year after surgery, using clinician and participant reporting: a multi-centre prospective cohort study
dc.typejournal-article
dc.typeArticle
plymouth.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/36426378
plymouth.volume24
plymouth.publisher-urlhttp://dx.doi.org/10.1016/j.lanepe.2022.100545
plymouth.publication-statusPublished
plymouth.journalThe Lancet Regional Health - Europe
dc.identifier.doi10.1016/j.lanepe.2022.100545
plymouth.organisational-group/Plymouth
plymouth.organisational-group/Plymouth/Faculty of Health
plymouth.organisational-group/Plymouth/Faculty of Health/Peninsula Medical School
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA
plymouth.organisational-group/Plymouth/REF 2021 Researchers by UoA/UoA01 Clinical Medicine
plymouth.organisational-group/Plymouth/Research Groups
plymouth.organisational-group/Plymouth/Research Groups/FoH - Applied Parkinson's Research
plymouth.organisational-group/Plymouth/Research Groups/Plymouth Institute of Health and Care Research (PIHR)
plymouth.organisational-group/Plymouth/Users by role
plymouth.organisational-group/Plymouth/Users by role/Academics
plymouth.organisational-group/Plymouth/Users by role/Researchers in ResearchFish submission
dc.publisher.placeEngland
dcterms.dateAccepted2022-10-27
dc.rights.embargodate2023-2-15
dc.identifier.eissn2666-7762
dc.rights.embargoperiodNot known
rioxxterms.versionofrecord10.1016/j.lanepe.2022.100545
rioxxterms.licenseref.urihttp://www.rioxx.net/licenses/all-rights-reserved
rioxxterms.licenseref.startdate2023-01
rioxxterms.typeJournal Article/Review


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