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Examination of The Predictive Power of Electromyography and Urodynamic Study in Patients with Cauda Equina Syndrome (Horse Tail Syndrome)

BACKGROUND: Cauda equina syndrome is a rare disorder that causes loss of Lumbar plexus function (nerve roots) lower than conus medullaris. No risk factor has been defined for this disease yet. Due to the high morbidity of Cauda equina syndrome and lack of sufficient information about the connection...

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Autores principales: Shahmohammadi, Mohammadreza, Khoshuod, Reza Jalil, Zali, Alireza, Seddeghi, Amir Saied, Kabir, Nima Mohseni
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AVICENA, d.o.o., Sarajevo 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5203747/
https://www.ncbi.nlm.nih.gov/pubmed/28077887
http://dx.doi.org/10.5455/aim.2016.24.328-331
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author Shahmohammadi, Mohammadreza
Khoshuod, Reza Jalil
Zali, Alireza
Seddeghi, Amir Saied
Kabir, Nima Mohseni
author_facet Shahmohammadi, Mohammadreza
Khoshuod, Reza Jalil
Zali, Alireza
Seddeghi, Amir Saied
Kabir, Nima Mohseni
author_sort Shahmohammadi, Mohammadreza
collection PubMed
description BACKGROUND: Cauda equina syndrome is a rare disorder that causes loss of Lumbar plexus function (nerve roots) lower than conus medullaris. No risk factor has been defined for this disease yet. Due to the high morbidity of Cauda equina syndrome and lack of sufficient information about the connection between the disease and urodynamic findings and EMG (Electromyography) findings, the need for this comprehensive study is felt. OBJECTIVE: The aim is to determine the predictive power of findings resulted from urodynamics and electromyography of perineal region and around sphincter in the clinical cure rate of urination in patients with urinary retention followed by Cauda equina syndrome. METHOD: Patients referred to Shohadaye Tajrish Hospital during the years 2009 to 2013, in case of having Cauda equina syndrome symptoms (confirmed with Lumbar MRI), were undergone urodynamic examination and perineal electromyography after surgical decompression action. These both assessments (urodynamic study and electromyography) were repeated during the follow-up of 15 patients in the first and sixth months after surgery and findings were compared with each other. RESULTS: Among the Urodynamic findings, Qmax (maximum urine flow) during three studies had a significant relationship with long-term recovery rate of patients (P <0.05). The relationship had been more valuable in follow-ups after one month (P = 0.0001). Also, BCI (Bladder Contractility Index) in all three studies had a significant relationship with clinical improvement in the ability to urinate (P <0.001). The residual urine (PVR) compared to two previous urodynamic findings showed a less significant relationship with clinical cure rate (P = 0.04). Among the findings of muscle-nerve (MUAP Fibrillation, Positive sharp way) none of them had a significant relationship with cure rate. CONCLUSION: Urodynamic finding, especially Qmax and bladder contractility index, can be considered as predictive indicators for patients’ recovery after surgery.
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spelling pubmed-52037472017-01-11 Examination of The Predictive Power of Electromyography and Urodynamic Study in Patients with Cauda Equina Syndrome (Horse Tail Syndrome) Shahmohammadi, Mohammadreza Khoshuod, Reza Jalil Zali, Alireza Seddeghi, Amir Saied Kabir, Nima Mohseni Acta Inform Med Original Paper BACKGROUND: Cauda equina syndrome is a rare disorder that causes loss of Lumbar plexus function (nerve roots) lower than conus medullaris. No risk factor has been defined for this disease yet. Due to the high morbidity of Cauda equina syndrome and lack of sufficient information about the connection between the disease and urodynamic findings and EMG (Electromyography) findings, the need for this comprehensive study is felt. OBJECTIVE: The aim is to determine the predictive power of findings resulted from urodynamics and electromyography of perineal region and around sphincter in the clinical cure rate of urination in patients with urinary retention followed by Cauda equina syndrome. METHOD: Patients referred to Shohadaye Tajrish Hospital during the years 2009 to 2013, in case of having Cauda equina syndrome symptoms (confirmed with Lumbar MRI), were undergone urodynamic examination and perineal electromyography after surgical decompression action. These both assessments (urodynamic study and electromyography) were repeated during the follow-up of 15 patients in the first and sixth months after surgery and findings were compared with each other. RESULTS: Among the Urodynamic findings, Qmax (maximum urine flow) during three studies had a significant relationship with long-term recovery rate of patients (P <0.05). The relationship had been more valuable in follow-ups after one month (P = 0.0001). Also, BCI (Bladder Contractility Index) in all three studies had a significant relationship with clinical improvement in the ability to urinate (P <0.001). The residual urine (PVR) compared to two previous urodynamic findings showed a less significant relationship with clinical cure rate (P = 0.04). Among the findings of muscle-nerve (MUAP Fibrillation, Positive sharp way) none of them had a significant relationship with cure rate. CONCLUSION: Urodynamic finding, especially Qmax and bladder contractility index, can be considered as predictive indicators for patients’ recovery after surgery. AVICENA, d.o.o., Sarajevo 2016-10 2016-11-01 /pmc/articles/PMC5203747/ /pubmed/28077887 http://dx.doi.org/10.5455/aim.2016.24.328-331 Text en Copyright: © 2016 Mohammadreza Shahmohammadi, Reza Jalil Khoshuod, Alireza Zali, Amir Saied Seddeghi, and Nima Mohseni Kabir http://creativecommons.org/licenses/by-nc/4.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Paper
Shahmohammadi, Mohammadreza
Khoshuod, Reza Jalil
Zali, Alireza
Seddeghi, Amir Saied
Kabir, Nima Mohseni
Examination of The Predictive Power of Electromyography and Urodynamic Study in Patients with Cauda Equina Syndrome (Horse Tail Syndrome)
title Examination of The Predictive Power of Electromyography and Urodynamic Study in Patients with Cauda Equina Syndrome (Horse Tail Syndrome)
title_full Examination of The Predictive Power of Electromyography and Urodynamic Study in Patients with Cauda Equina Syndrome (Horse Tail Syndrome)
title_fullStr Examination of The Predictive Power of Electromyography and Urodynamic Study in Patients with Cauda Equina Syndrome (Horse Tail Syndrome)
title_full_unstemmed Examination of The Predictive Power of Electromyography and Urodynamic Study in Patients with Cauda Equina Syndrome (Horse Tail Syndrome)
title_short Examination of The Predictive Power of Electromyography and Urodynamic Study in Patients with Cauda Equina Syndrome (Horse Tail Syndrome)
title_sort examination of the predictive power of electromyography and urodynamic study in patients with cauda equina syndrome (horse tail syndrome)
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5203747/
https://www.ncbi.nlm.nih.gov/pubmed/28077887
http://dx.doi.org/10.5455/aim.2016.24.328-331
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