Cauda Equina Syndrome Overview
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Questions and Answers

Which journal published the highest number of articles among the top 50 cited articles?

  • European Spine Journal
  • British Journal of Neurosurgery
  • Spine (correct)
  • Journal of Neurosurgery
  • In which decade were the most articles on cauda equina syndrome published?

  • 1980s
  • 2000s (correct)
  • 1990s
  • 1950s
  • How many articles were published in the British Medical Journal related to the top 50 cited articles?

  • 2 (correct)
  • 3
  • 5
  • 4
  • Which article represents the earliest publication related to cauda equina syndrome?

    <p>Paralysis of the bladder and associated neurological sequelae of spinal anaesthesia</p> Signup and view all the answers

    How many articles were published in the Journal of Bone and Joint Surgery?

    <p>3</p> Signup and view all the answers

    What condition can lead to permanent neurological deficits if not diagnosed and addressed promptly?

    <p>Cauda equina syndrome</p> Signup and view all the answers

    Which journal had the same number of articles published as the European Spine Journal?

    <p>British Journal of Neurosurgery</p> Signup and view all the answers

    What was the primary objective of the authors in this article?

    <p>Identify the top 50 most impactful articles on CES</p> Signup and view all the answers

    What bibliographic database was used for article selection in the study?

    <p>Web of Science Core Collection</p> Signup and view all the answers

    Which of the following journals featured only 2 articles among the top cited articles?

    <p>Anesthesia and Analgesia</p> Signup and view all the answers

    Which article was written most recently in the context of cauda equina syndrome?

    <p>Timing of surgical intervention in cauda equina syndrome: a systematic critical review</p> Signup and view all the answers

    How many articles matched the search criteria for cauda equina syndrome?

    <p>2096</p> Signup and view all the answers

    In what year did the authors conduct their search for impactful articles on CES?

    <p>2021</p> Signup and view all the answers

    What types of prognoses can lead to cauda equina syndrome?

    <p>Retropulsed fracture fragments, disc herniations, and epidural abscesses</p> Signup and view all the answers

    What citation range was noted for the top 50 impactful articles on CES?

    <p>43 to 439</p> Signup and view all the answers

    What element was NOT recorded while analyzing the top articles on CES?

    <p>Author’s age</p> Signup and view all the answers

    What is the estimated false positive rate for the clinical diagnosis of cauda equina syndrome?

    <p>43%</p> Signup and view all the answers

    Which symptom is widely regarded as the most important factor for diagnosing cauda equina syndrome?

    <p>Bladder dysfunction</p> Signup and view all the answers

    What is the range of timelines for the progression of symptoms related to cauda equina syndrome?

    <p>Days to months</p> Signup and view all the answers

    Which of the following conditions has the same number of articles as anesthetic complications in the table?

    <p>Disc Herniations</p> Signup and view all the answers

    Which factor is NOT mentioned as a common presentation for cauda equina syndrome?

    <p>Nerve root damage</p> Signup and view all the answers

    What is a significant challenge in diagnosing cauda equina syndrome?

    <p>Unclear initial symptoms</p> Signup and view all the answers

    During which annual meeting was the diagnosis and treatment of cauda equina syndrome discussed?

    <p>British Association of Spine Surgeons</p> Signup and view all the answers

    What is the total number of articles focused on fractures/dislocations as per the table?

    <p>2 articles</p> Signup and view all the answers

    What does the author propose as a potential solution for the complications observed in the patients?

    <p>Ceiling to local anesthetic dose</p> Signup and view all the answers

    Which publication discusses irreversible conduction block caused by high concentrations of local anesthetics?

    <p>Irreversible conduction block in isolated nerve</p> Signup and view all the answers

    What was the effect of 5% lidocaine or 0.5% tetracaine on the isolated nerves?

    <p>Irreversible total conduction blockade</p> Signup and view all the answers

    What was the focus of the 2000 article by Ahn et al.?

    <p>Clinical outcomes of patients with surgical decompression</p> Signup and view all the answers

    How many patient outcomes were evaluated in the meta-analysis mentioned?

    <p>322 patient outcomes</p> Signup and view all the answers

    What characteristic of the nerves exposed to lower concentrations of local anesthetics was observed?

    <p>Partial conduction block</p> Signup and view all the answers

    What complication was noted in all four patients mentioned in the study?

    <p>Conduction block in the nerves</p> Signup and view all the answers

    Which local anesthetic concentration was NOT mentioned as causing irreversible conduction block?

    <p>1% bupivacaine</p> Signup and view all the answers

    Which of the following factors can affect the long-term outcome for patients with cauda equina syndrome?

    <p>Early diagnosis and treatment</p> Signup and view all the answers

    What is a common cause of cauda equina syndrome in the context of surgical procedures?

    <p>Epidural anesthesia</p> Signup and view all the answers

    What is the significance of timing in surgical interventions for cauda equina syndrome?

    <p>Earlier decompression leads to better outcomes</p> Signup and view all the answers

    Which of the following conditions is least likely to cause cauda equina syndrome?

    <p>Acute breast surgery</p> Signup and view all the answers

    What aspect of cauda equina syndrome is directly impacted by anatomical variations in the lumbar spinal canal?

    <p>Risk of developing urinary retention</p> Signup and view all the answers

    What kind of treatment is primarily suggested for cauda equina syndrome?

    <p>Surgical decompression</p> Signup and view all the answers

    Which of the following complications is frequently associated with cauda equina syndrome?

    <p>Bowel dysfunction</p> Signup and view all the answers

    In the context of cauda equina syndrome, what does a meta-analysis suggest about urinary retention?

    <p>It can necessitate surgical intervention</p> Signup and view all the answers

    Study Notes

    Cauda Equina Syndrome (CES)

    • A rare condition leading to permanent neurological deficits if not diagnosed and treated promptly
    • Prognosis varies, including retropulsed fracture fragments, disc herniations, and epidural abscesses
    • CES is often caused by compression of sacral and lumbar nerve roots
    • The exact symptoms of CES are unclear, but often include:
      • Sensory loss
      • Bladder dysfunction (often regarded as the most important indicator for diagnosis)
      • Back pain
      • Weakness
    • Symptoms can progress rapidly over days or slowly over months, making diagnosis challenging

    Research on CES

    • 2096 articles on CES were identified in the Web of Science Core Collection bibliographic database from 1900 to 2021
    • The top 50 most cited articles ranged from 43 to 439 citations
    • The most common journals for these articles are:
      • Spine
      • Anesthesiology
      • British Journal of Neurosurgery
      • European Spine Journal
      • Journal of Neurosurgery
      • The Journal of Bone and Joint Surgery
    • The 2000s was the most active decade for CES publications (20 articles)
    • The oldest article is from 1938 and the most recent is from 2014
    • The most common topics are:
      • Disc Herniations
      • Anesthetic Complications
      • Timing of Surgical Intervention
    • False positive rate for CES is 43%

    Key Studies

    • Lambert et al. (1991)
      • Four patients developed CES, presumably due to a high local anesthetic dose during epidural anesthesia
      • Authors suggest a ceiling to local anesthetic dose as a potential solution to this complication
    • Wilson (1969)
      • Examined the significance of a small lumbar spinal canal and cauda equina compression syndromes due to spondylosis
    • Drasner et al. (1992)
      • Investigated CES following intended epidural anesthesia
    • McCarthy et al. (2007)
      • Analyzed factors impacting functional and sphincteric outcome in CES
    • DeLong et al. (2008)
      • Meta-analyzed observational studies on the timing of surgery in CES with urinary retention
    • Orendácová et al. (2001)
      • Reviewed the history and current understanding of CES
    • Tatter and Cosgrove (1994)
      • Reported a case of CES caused by hemorrhage into a lumbar synovial cyst
    • Delamarter et al. (1991)
      • Studied the neurological recovery following early, late, or immediate decompression in CES
    • Qureshi and Sell (2007)
      • Evaluated the influence of timing on surgical outcomes in CES treated by surgical decompression
    • Ahn et al. (2000)
      • Analyzed surgical outcomes of CES secondary to lumbar disc herniation, focusing on clinical outcomes of patients with surgical decompression at varying lengths following the onset of symptoms.

    Additional Notes

    • The pathophysiology of CES remains unclear
    • There is no consensus on the exact symptoms of CES
    • The British Association of Spine Surgeons stated that clinical signals for CES are diverse and have no predictive value on patient outcomes

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    Description

    This quiz explores Cauda Equina Syndrome (CES), a rare but serious neurological condition resulting from nerve root compression in the lumbar and sacral regions. Learn about its symptoms, the importance of timely diagnosis, and research trends in CES management. Test your knowledge on effective treatment methods and the latest findings from various studies.

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