The degree of neurological dysfunction at surgery is the most significant determinant of prognosis: outcomes are worse for patients with CES with retention (CESR) than for patients with incomplete CES (CESI). Delay to surgery for patients with CESI is likely to adversely affect prognosis.[7]Barraclough K. Cauda equina syndrome. BMJ. 2021 Jan 12;372:n32.
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[39]Chau AM, Xu LL, Pelzer NR, et al. Timing of surgical intervention in cauda equina syndrome: a systematic critical review. World Neurosurg. 2014 Mar-Apr;81(3-4):640-50.
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[44]Srikandarajah N, Boissaud-Cooke MA, Clark S, et al. Does early surgical decompression in cauda equina syndrome improve bladder outcome? Spine (Phila Pa 1976). 2015 Apr 15;40(8):580-3.
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Ongoing bladder, bowel, and/or sexual dysfunction, as well as pain, leg weakness, and sensory loss, have been reported in up to 60% of people after surgery for CES, but improvement is still possible for several years after surgery.[46]Hazelwood JE, Hoeritzauer I, Pronin S, et al. An assessment of patient-reported long-term outcomes following surgery for cauda equina syndrome. Acta Neurochir (Wien). 2019 Sep;161(9):1887-94.
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[55]Korse NS, Veldman AB, Peul WC, et al. The long term outcome of micturition, defecation and sexual function after spinal surgery for cauda equina syndrome. PLoS One. 2017;12(4):e0175987.
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