Document Detail


Cauda equina syndrome in ankylosing spondylitis (the CES-AS syndrome): meta-analysis of outcomes after medical and surgical treatments.
MedLine Citation:
PMID:  11586143     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The cauda equina syndrome in ankylosing spondylitis (the CES-AS syndrome) is marked by slow, insidious progression and a high incidence of dural ectasia in the lumbosacral spine. A high index of suspicion for this problem must be maintained when evaluating the patient with ankylosing spondylitis with a history of incontinence and neurologic deficit on examination. There has been disagreement in the literature as to whether surgical treatment is warranted for this condition. A meta-analysis was thus performed comparing outcomes with treatment regimens. Our results suggest that leaving these patients untreated or treating with steroids alone is inappropriate. Nonsteroidal antiinflammatory drugs may improve back pain but do not improve neurologic deficit. Surgical treatment of the dural ectasia, either by lumboperitoneal shunting or laminectomy, may improve neurologic dysfunction or halt the progression of neurologic deficit.
Authors:
N U Ahn; U M Ahn; L Nallamshetty; B D Springer; J M Buchowski; L Funches; E S Garrett; J P Kostuik; K M Kebaish; P D Sponseller
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Publication Detail:
Type:  Case Reports; Journal Article; Meta-Analysis    
Journal Detail:
Title:  Journal of spinal disorders     Volume:  14     ISSN:  0895-0385     ISO Abbreviation:  J Spinal Disord     Publication Date:  2001 Oct 
Date Detail:
Created Date:  2001-10-04     Completed Date:  2001-12-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8904842     Medline TA:  J Spinal Disord     Country:  United States    
Other Details:
Languages:  eng     Pagination:  427-33     Citation Subset:  IM    
Affiliation:
Department of Orthopaedic Surgery, Johns Hopkins University, Baltimore, Maryland, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Inflammatory Agents, Non-Steroidal / therapeutic use
Humans
Logistic Models
Lumbosacral Region / surgery
Male
Odds Ratio
Polyradiculopathy / drug therapy,  surgery*
Spinal Cord Injuries / diagnosis,  surgery
Spondylitis, Ankylosing / drug therapy,  surgery*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents, Non-Steroidal

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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