Cauda equina syndrome with urinary retention as a postoperative complication of lumbar spine surgery: A case report

Abstract

BACKGROUND

Cauda equina syndrome (CES) is characterized by a group of symptoms that may be caused by inflammation, spinal cord compression, venous congestion, or ischemia. This syndrome is commonly an indication for surgical intervention but has not been determined as a postoperative complication following surgery for lumbar spine disease.

CASE SUMMARY

To report the case of a 54-year-old male patient who had CES following spinal surgery, with no obvious compression lesions found during re-exploration, suggesting that vascular insufficiency may have contributed to the condition. Furthermore, a series of urodynamic studies on bladder recovery patterns in such complications have also been investigated.

CONCLUSION

Postoperative CES requires urgent imaging and exploration to rule out compression; noncompressive cases, including vascular insufficiency may performed conservative management.

Keywords: Cauda equina syndrome; Lumbar spine surgery; Urinary retention; Urodynamic study; Postoperative complication; Case report

Core Tip: This report discusses postoperative Cauda equina syndrome (CES) with neurogenic bladder as a potential complication of spinal surgery. Emergency imaging is crucial to exclude spinal cord compression. If stenosis remains, further exploration is needed. Compressive lesions might not explain the patient's symptoms, suggesting vascular insufficiency. In noncompressive CES, conservative management may be appropriate. Postoperative cystometrogram findings might initially show no bladder contraction and delayed first sensation, with contractility improving later.