Postoperative Cauda Equina Syndrome: A Report On 10 Patients with Literature Review

Background: Cauda equina syndrome (CES) is a serious condition used to describe the signs and symptoms of patients with compressive neuropathy of multiple lumbar and sacral roots, though in rare cases no compression was discovered, and probably the pathology is related to ischemic changes, this syndrome is well known as an indication for urgent lumbar surgery. It is very rarely seen after surgery, in this study the authors described 10 cases of CES that occurred following uneventful lumbar spine procedures, all had open lumbar decompression. Patients and methods: Preoperative, operative and post-operative management will be discussed. Special emphasis on the high index of suspicion and the value of MRI as a diagnostic procedure. The age range between 35 to 70 years, six were female and four were males, six had decompression for lumbar canal stenosis, four had CES following lumbar discectomy. Eight had urgent decompression after CES while two were treated conservatively. All presented with cardinal clinical features of CES, in seven patients it was complete while in three patients it was incomplete. The relevant literatures were reviewed. Conclusion: High index of suspicion is required for early detection of postoperative CES Special surgical technique may reduce the incidence of this syndrome. Wide lumbar decompression or other procedures is urgently required when there is positive MRI findings of compression. Full recovery is not always possible.