Rates of Future Lumbar Fusion in Patients with Cauda Equina Syndrome Treated With Decompression.
Journal
Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews
ISSN: 2474-7661
Titre abrégé: J Am Acad Orthop Surg Glob Res Rev
Pays: United States
ID NLM: 101724868
Informations de publication
Date de publication:
01 Nov 2022
01 Nov 2022
Historique:
received:
30
05
2022
accepted:
17
08
2022
entrez:
2
11
2022
pubmed:
3
11
2022
medline:
5
11
2022
Statut:
epublish
Résumé
The long-term risk of conversion to lumbar fusion is ill-defined for patients with cauda equina syndrome (CES) treated with decompression. This study aimed to identify the rates of fusion in patients with CES and compare those rates with a matched lumbar spinal stenosis (LSS) group. Patients with CES who underwent decompression were identified in a national database and matched to control patients with LSS. The rates of conversion to fusion were identified and compared. Multivariate logistic regression analysis identified independently associated risk factors. A subanalysis was conducted after stratifying by timing between CES diagnosis and decompression. The rate of lumbar fusion in the CES cohort was 3.6% after 1 year, 6.7% after 3 years, and 7.8% after 5 years, significantly higher than the LSS control group at all time points (1 year: 1.6%, P = 0.001; 3 years: 3.0%, P < 0.001; 5 years: 3.8%, P < 0.001). CES was independently associated with increased risk of conversion to fusion (odds ratio: 2.13; 95% confidence interval: 1.56 to 2.97; P < 0.001). Surgical timing was not associated with risk of conversion to fusion. After 5 years, 7.8% of patients with CES underwent fusion, a markedly higher rate compared with patients with LSS. Counseling patients with CES on this increased risk of future surgery is important for patient education and satisfaction.
Identifiants
pubmed: 36322672
doi: 10.5435/JAAOSGlobal-D-22-00153
pii: 01979360-202211000-00001
pmc: PMC9633085
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Informations de copyright
Copyright © 2022 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Orthopaedic Surgeons.
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