Cauda equina syndrome secondary to giant lumbar disc herniation

Objetive: To determine the relation between clinical symptoms at presentation and the outcomes in a group of patients with CES secondary lumbar disc herniation. Patients and method: We present 5 patients with CES secondary to a giant lumbar disc herniation confirmed by MRI, submitted to discectomy and early decompression of the spinal canal. Results: Urgent surgical decompression was performed, all the patients were presenting visceral dysfunction on admission. Despite early treatment, only three patients have experienced a complete recovery of the visceral dysfunction and motor and sensory previous symptoms. Conclusions: The influence in a delay in the surgical treatment may well be overestimated due to the classic recommendations of the first published studies. However, early decompression is not detrimental, and may help to prevent an incomplete lesion progressing to complete sphincter paralysis.