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

Overview

Journal Acta Inform Med

Specialty General Medicine

Date 2017 Jan 13

PMID 28077887

Citations 1

Authors

Mohammadreza Shahmohammadi

Reza Jalil Khoshuod

Alireza Zali

Amir Saied Seddeghi

Nima Mohseni Kabir

Affiliations

Soon will be listed here.

Abstract

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.

Citing Articles

Patient-Reported Bladder, Bowel, and Sexual Function After Cauda Equina Syndrome Secondary to a Herniated Lumbar Intervertebral Disc.

Lam J, deSouza R, Laycock J, Perera D, Burford C, Khan B Top Spinal Cord Inj Rehabil. 2021; 26(4):290-303.

PMID: 33536735 PMC: 7831285. DOI: 10.46292/sci19-00065.

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