The aim of this study was to establish an incidence rate of traumatic cauda equina syndrome in Victoria and to describe its long-term outcomes.
This was a registry-based cohort study, involving 94 patients with a diagnosis of cauda equina syndrome following trauma from 2010 to 2022 in Victoria. Patients were routinely followed up at six, 12, and 24 months, with a focus on EQ-5D and return to work outcomes. An additional interview was undertaken, at a median 6.9 years post injury to collect the EQ-5D outcomes, as well as bowel and bladder symptoms. Descriptive statistics were used to analyse data. Mixed effects regression modelling was used to model EQ-5D outcomes over time.
Most patients with this injury were men with a median age of 41 years, and the most common cause was road trauma. The average incidence rate was 1.61 per million per year. Most patients reported problems on the EQ- 5D at all four follow-up time points. There was no clear improvement in EQ-5D outcomes over time. Almost half (47%) of patients had not returned to work 24 months after injury. Many patients experience bowel and bladder symptoms, with the additional follow-up revealing 41% of patients experience constipation, and 51% report almost losing bladder continence at least weekly.
Overall, this is a rare injury and most patients experience some long-term sequelae. This study was the first cohort study to examine EQ-5D, return to work, and sphincter outcomes, and was the first to establish an incidence rate for this injury.