The Reoperation, Readmission, and Complication Rates at 30 Days Following Lumbar Decompression for Cauda Equina Syndrome

Authors

Ryan Filler, Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, USA.
Rusheel Nayak, Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, USA.
Jacob Razzouk, Department of Orthopaedic Surgery, School of Medicine, Loma Linda University, Loma Linda, USA.
Omar Ramos, Spine Surgery, Twin Cities Spine Center, Minneapolis, USA.
Damien Cannon, Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, USA.
Zachary Brandt, School of Medicine, Loma Linda University, Loma Linda, USA.
Savyasachi C. Thakkar, Orthopaedic Surgery, Johns Hopkins Health System, Baltimore, USA.
Philip Parel, Department of Orthopaedic Surgery, George Washington University School of Medicine and Health Sciences, Washington D.C., USA.
Anthony Chiu, Department of Orthopaedics, University of Maryland, Baltimore, USA.
Wayne Cheng, Division of Orthopaedic Surgery, Jerry L. Pettis VA Medical Center, Loma Linda, USA.
Olumide Danisa, Department of Orthopaedic Surgery, Loma Linda University Medical Center, Loma Linda, USA.

Document Type

Journal Article

Publication Date

11-1-2023

Journal

Cureus

Volume

15

Issue

11

DOI

10.7759/cureus.49059

Keywords

cauda equina syndrome (ces); lumbar decompression; pearldiver; readmission; reoperation

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.

APA Citation

Filler, Ryan; Nayak, Rusheel; Razzouk, Jacob; Ramos, Omar; Cannon, Damien; Brandt, Zachary; Thakkar, Savyasachi C.; Parel, Philip; Chiu, Anthony; Cheng, Wayne; and Danisa, Olumide, "The Reoperation, Readmission, and Complication Rates at 30 Days Following Lumbar Decompression for Cauda Equina Syndrome" (2023). GW Authored Works. Paper 3781.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/3781

Department

School of Medicine and Health Sciences Student Works