Author(s): Srikandarajah N.; Clark S.; Wilby M.; Noble A.; Williamson P.; Marson T.
Source: British Journal of Neurosurgery; 2018; vol. 32 (no. 1); p. 81
Publication Date: 2018
Publication Type(s): Conference Abstract
Abstract:Objectives: The time recorded before a patient receives an operation for Cauda Equina Syndrome (CES) after symptom onset is believed to be one of the important factors to their outcome. We intend to analyse how it is defined in the literature. Design: Systematic Literature Review was performed using PRISMA guidelines registered on the COMET database (824). Subjects: Adult patients who had an operation for CES. Methods: Databases of Medline, Embase, CINAHL Plus and registries were searched from 1/1/1990 to 30/9/2016 with the term ‘Cauda Equina Syndrome.’ Appropriate restrictive criteria and a data extraction form were used to document definition of the starting point and categorisation of timing to surgery. Results: 61 articles were included once restrictive criteria was applied to all sources (5,430 in total). Details regarding the time duration before an operation were reported in 38 (62.3%) studies. Only 29 (47.5%) of the studies reported time duration from CES symptom onset. 12 of these articles did not define the exact symptoms used. The remaining papers that did define the actual symptoms, had different symptoms defined. There was also variation in the way timing was categorised between papers. Conclusions: The review highlights significant variation in the way papers define and report the timing to surgery for CES. A metaanalysis of the outcomes is not possible if the definition of the time to surgery is different between articles. There needs to be standardisation of this for future studies.