Epidemiology of Conus-Cauda Equina syndrome in the Spinal Unit of the Vicenza General Hospital

摘要

The Spinal Unit of the General Hospital of Vicenza (VGH) admits patients with Spinal Cord Injury (SCI) after discharge from Neurosurgery and Reanimation Divisions of Veneto Hospitals. The Conus-Cauda Equina syndrome is characterized by bladder and intestines areflexia, pelvic and legs flaccid paralysis and anesthesia. This “rare disease” affects mainly adults and the most common etiology is traumatic lumbar slipped disc. Demographic data, etiology, the need of surgery, duration of hospitalization, bladder managements, and mobility at admission and discharge were revisited in 159 stories of SCI patients at their first admission to the Spinal Unit of VGH from January 1, 2005 to June 30, 2008. In our sample the etiology was traumatic in 12 patients, non-traumatic in 7 patients. 4 and 15 patients were classified complete and incomplete lesion, respectively (ASIA Scale). Mobilty: of the 4 patients with complete lesion, at discharge 2 used only wheelchair for self transfer, 1 used common leg braces with walking aid (e.g. crutches) and 1 just one crutch. Of the 15 incomplete-lesions, at the discharge 10 did not need wheelchair for transfer: among them 2 used walker (1 with leg braces); 4 used walking aids (2 with leg brace); 3 used just one crutch, 1 used AFO. All patients have been treated with conventional rehabilitation strategies for enhancing lower limbs function. At the same time these patients had active exercise for upper limbs and training for daily mobility tasks (transferring, bed mobility and sitting). This is a pretty opportunity to engage a long and wide road that leaded us to be partners in the 2008Rise2-Italy Project. We have not long experience with electrical stimulation, but we believe that we have to consider this approach to give more chance to our patients in their rehabilitation, possibly in less time.i