Introduction: Cauda equina syndrome (CES) is a severe and potentially debilitating condition caused by compression of the lumbosacral nerve roots, often resulting in motor, sensory, and autonomic dysfunctions, including bladder and bowel impairment. Degenerative lumbar spine stenosis a relatively rare cause for CES, and it requires urgent surgical decompression to prevent permanent neurological deficits. While immediate intervention is crucial, there is limited data on the long-term outcomes following surgery. This study aims to evaluate the long-term clinical and functional outcomes of patients with CES due to degenerative lumbar spine stenosis, providing insight into the effectiveness of surgical treatment.
Methods: A retrospective analysis was conducted on 19 patients who presented with cauda equina syndrome secondary to degenerative lumbar spine stenosis and underwent decompressive surgery between January 2017 and August 2023. Clinical outcomes were assessed using postoperative neurological recovery, functional status (Oswestry Disability Index), bladder and bowel function, and patient-reported outcomes. Radiologic assessment was performed through postoperative MRI and X-rays. The follow-up period ranged from 2 to 7 years, and the incidence of reoperation and long-term complications was recorded.
Results: At the final follow-up, 14 patients (73%) demonstrated significant neurological recovery, with improved motor and sensory function. Bladder and bowel function improved in 12 patients (63%), while 7 patients continued to experience residual dysfunction. Radiologic follow-up confirmed adequate decompression in all cases, with no evidence of recurrent stenosis. Long-term complications included chronic pain in 5 patients and postoperative infection in 2 cases.
Conclusions: Surgical decompression for cauda equina syndrome related to degenerative lumbar spine stenosis leads to favorable long-term outcomes in terms of neurological recovery and functional improvement. However, residual bladder and bowel dysfunction remains a challenge in a subset of patients. Early diagnosis and prompt surgical intervention appear to be critical for optimal recovery.