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General Orthopaedics

Is there a cauda equina syndrome body habitus?

British Orthopaedic Association 2012 Annual Congress



Abstract

Background

Cauda equina syndrome (CES) is a physical process. There is compression of the cauda equina resulting in arrest of the electrochemical signal from the central nervous system. Previous studies have demonstrated that anthropomorphic features influence nerve conduction properties.

Aim

We therefore sought to if there was an association between biophysical parameters and CES.

Setting and design

Single centre retrospective comparative study

Method and materials

We analysed consecutive patients who had elective lumbar discectomy. Demographic data-including age, gender, height, weight and BMI were recorded. Identical information was collected in consecutive patients who underwent emergency lumbar discectomy for MRI-proven CES.

Results

There were 40 patients who underwent emergency surgery for CES. There were 22 women and 18 men with a mean age of 38.6 years. 92 patients underwent elective lumbar discectomy. There were 45 men and 47 women with a mean age of 44 years. Patient undergoing emergency discectomy for CES were significantly heavier (p=0.001) and had a significantly higher BMI (p< 0.0005) compared to the elective surgery cohort. The mean difference in weight and BMI were 11.2 kg (95% confidence interval: 3.8–18.7) and 4.6kg/m2 (95% confidence interval: 2.4–6.9) respectively. The CES-group was also slightly younger (mean difference 5.4 years 95% CI: 1.7–9.8 p=0.01). There was no statistically significant difference between the heights of the two groups or the gender ratio. Multivariate binary logistic regression showed increasing weight to be associated with the increasing odds of CES (P< 0.0005). In contrast increasing height was correlated with a reducing likelihood of CES (P< 0.01). Increasing BMI was associated with increased odds of CES (p< 0.0005).

Conclusion

This is the first study to relate anthropometric features to CES. Our study observed that increasing BMI is linked with the increased odds of CES syndrome as was increasing weight and decreasing height.