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Body mass index has an impact on preoperative symptoms but not clinical outcome in acute cauda equina syndrome

Cauda equina syndrome (CES) presents a surgical emergency with treatment required within 48 h. Symptoms include reduced saddle sensation, micturition difficulties, and/or anal sphincter impairment. Controversy exists regarding the effect on and coincidence of overweight with CES. We performed a retr...

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Autores principales: Butenschoen, Vicki M., Abulhala, Shadi, Meyer, Bernhard, Gempt, Jens
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8260780/
https://www.ncbi.nlm.nih.gov/pubmed/34230508
http://dx.doi.org/10.1038/s41598-021-92969-4
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author Butenschoen, Vicki M.
Abulhala, Shadi
Meyer, Bernhard
Gempt, Jens
author_facet Butenschoen, Vicki M.
Abulhala, Shadi
Meyer, Bernhard
Gempt, Jens
author_sort Butenschoen, Vicki M.
collection PubMed
description Cauda equina syndrome (CES) presents a surgical emergency with treatment required within 48 h. Symptoms include reduced saddle sensation, micturition difficulties, and/or anal sphincter impairment. Controversy exists regarding the effect on and coincidence of overweight with CES. We performed a retrospective case–control study of all patients treated surgically for acute complete and incomplete CES in our neurosurgical department from 2009 to 2020, focusing on the preoperative BMI and postoperative neurological outcome. In addition, we performed a comprehensive literature review. Fifty patients with CES were included, of whom 96% suffered from a decompensated lumbar spinal stenosis or disc prolapse between the L4/5 and L5/S1 levels. Our cohort population was overweight but not obese: mean BMI was 27.5 kg/m(2), compared with 27.6 kg/m(2) in patients with degenerative spine surgery. BMI did not significantly influence the postoperative outcome, but it did affect preoperative symptoms and surgery duration. Symptom duration significantly differed depending on the underlying cause for CES. The literature review revealed sparse evidence, with only four clinical case series presenting contradictory results. We provide a comprehensive literature review on the current evidence regarding CES and obesity and conclude that we did not observe an association between obesity and CES occurrence. Patients with CES and other degenerative spinal pathologies belong to an overweight but not obese population. Body Mass Index has an impact on preoperative symptoms but not clinical outcome in acute CES.
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spelling pubmed-82607802021-07-08 Body mass index has an impact on preoperative symptoms but not clinical outcome in acute cauda equina syndrome Butenschoen, Vicki M. Abulhala, Shadi Meyer, Bernhard Gempt, Jens Sci Rep Article Cauda equina syndrome (CES) presents a surgical emergency with treatment required within 48 h. Symptoms include reduced saddle sensation, micturition difficulties, and/or anal sphincter impairment. Controversy exists regarding the effect on and coincidence of overweight with CES. We performed a retrospective case–control study of all patients treated surgically for acute complete and incomplete CES in our neurosurgical department from 2009 to 2020, focusing on the preoperative BMI and postoperative neurological outcome. In addition, we performed a comprehensive literature review. Fifty patients with CES were included, of whom 96% suffered from a decompensated lumbar spinal stenosis or disc prolapse between the L4/5 and L5/S1 levels. Our cohort population was overweight but not obese: mean BMI was 27.5 kg/m(2), compared with 27.6 kg/m(2) in patients with degenerative spine surgery. BMI did not significantly influence the postoperative outcome, but it did affect preoperative symptoms and surgery duration. Symptom duration significantly differed depending on the underlying cause for CES. The literature review revealed sparse evidence, with only four clinical case series presenting contradictory results. We provide a comprehensive literature review on the current evidence regarding CES and obesity and conclude that we did not observe an association between obesity and CES occurrence. Patients with CES and other degenerative spinal pathologies belong to an overweight but not obese population. Body Mass Index has an impact on preoperative symptoms but not clinical outcome in acute CES. Nature Publishing Group UK 2021-07-06 /pmc/articles/PMC8260780/ /pubmed/34230508 http://dx.doi.org/10.1038/s41598-021-92969-4 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Article
Butenschoen, Vicki M.
Abulhala, Shadi
Meyer, Bernhard
Gempt, Jens
Body mass index has an impact on preoperative symptoms but not clinical outcome in acute cauda equina syndrome
title Body mass index has an impact on preoperative symptoms but not clinical outcome in acute cauda equina syndrome
title_full Body mass index has an impact on preoperative symptoms but not clinical outcome in acute cauda equina syndrome
title_fullStr Body mass index has an impact on preoperative symptoms but not clinical outcome in acute cauda equina syndrome
title_full_unstemmed Body mass index has an impact on preoperative symptoms but not clinical outcome in acute cauda equina syndrome
title_short Body mass index has an impact on preoperative symptoms but not clinical outcome in acute cauda equina syndrome
title_sort body mass index has an impact on preoperative symptoms but not clinical outcome in acute cauda equina syndrome
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8260780/
https://www.ncbi.nlm.nih.gov/pubmed/34230508
http://dx.doi.org/10.1038/s41598-021-92969-4
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