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Abstract：
Background and objective Cauda equina syndrome (CES) is considered a surgical emergency, and its primary treatment involves decompression of the nerve roots, typically in the form of discectomy or laminectomy. The primary aim of this study was to determine the complication, reoperation, and readmission rates within 30 days of surgical treatment of CES secondary to disc herniation by using the PearlDiver database (PearlDiver Technologies, Colorado Springs, CO). The secondary aim was to assess preoperative risk factors for a higher likelihood of complication occurrence within 30 days of surgery for CES. Methods A total of 524 patients who had undergone lumbar discectomy or laminectomy for CES were identified. The outcome measures were 30-day reoperation rate for revision decompression or lumbar fusion, and 30-day readmissions related to surgery. The patient data collected included medical history and surgical data including the number of levels of discectomy and laminectomy. Results Based on our findings, intraoperative dural tears, valvular heart disease, and fluid and electrolyte abnormalities were significant risk factors for readmission to the hospital within 30 days following surgery for CES. The most common postoperative complications were as follows: visits to the emergency department (63 patients, 12%), surgical site infection (21 patients, 4%), urinary tract infection (14 patients, 3%), and postoperative anemia (11 patients, 2%). Conclusions In the 30-day period following lumbar decompression for cauda equina syndrome, our findings demonstrated an 8% reoperation rate and 17% readmission rate. Although CES is considered an indication for urgent surgery, gaining awareness about reoperation, readmission, and complication rates in the immediate postoperative period may help calibrate expectations and inform medical decision-making.
摘要：
背景和目的马尾综合征（CES）被认为是外科急症，其主要治疗包括神经根减压，通常以椎间盘切除术或椎板切除术的形式。这项研究的主要目的是确定并发症，再操作,通过使用PearlDiver数据库（PearlDiverTechnologies，科罗拉多斯普林斯,CO).次要目的是评估术前风险因素，以评估CES手术后30天内并发症发生的可能性。方法对524例接受腰椎间盘切除术或椎板切除术的患者进行分析。结果测量为30天再次手术率，进行翻修减压或腰椎融合术。与手术相关的30天再入院。收集的患者数据包括病史和手术数据，包括椎间盘切除术和椎板切除术的级别数。结果根据我们的发现，术中硬脑膜撕裂，心脏瓣膜病,液体和电解质异常是CES手术后30天内再次入院的重要危险因素。最常见的术后并发症如下：急诊就诊（63例，12%），手术部位感染（21例，4%),尿路感染（14例，3%),和术后贫血（11例，2%)。结论在腰椎减压治疗马尾神经综合征后30天内,我们的研究结果表明,再手术率为8%,再入院率为17%.尽管CES被认为是紧急手术的适应症，提高对再手术的认识，重新接纳,术后即刻的并发症发生率可能有助于校准预期并为医疗决策提供信息.
