title: Examination of The Predictive Power of Electromyography and Urodynamic Study in Patients with Cauda Equina Syndrome (Horse Tail Syndrome).
abstract: BACKGROUND
  Cauda equina syndrome is a rare disorder that causes loss of Lumbar plexus function (nerve roots) lower than conus medullaris. No risk factor has been defined for this disease yet. Due to the high morbidity of Cauda equina syndrome and lack of sufficient information about the connection between the disease and urodynamic findings and EMG (Electromyography) findings, the need for this comprehensive study is felt.
  
  
  OBJECTIVE
  The aim is to determine the predictive power of findings resulted from urodynamics and electromyography of perineal region and around sphincter in the clinical cure rate of urination in patients with urinary retention followed by Cauda equina syndrome.
  
  
  METHODS
  Patients referred to Shohadaye Tajrish Hospital during the years 2009 to 2013, in case of having Cauda equina syndrome symptoms (confirmed with Lumbar MRI), were undergone urodynamic examination and perineal electromyography after surgical decompression action. These both assessments (urodynamic study and electromyography) were repeated during the follow-up of 15 patients in the first and sixth months after surgery and findings were compared with each other.
  
  
  RESULTS
  Among the Urodynamic findings, Qmax (maximum urine flow) during three studies had a significant relationship with long-term recovery rate of patients (P <0.05). The relationship had been more valuable in follow-ups after one month (P = 0.0001). Also, BCI (Bladder Contractility Index) in all three studies had a significant relationship with clinical improvement in the ability to urinate (P <0.001). The residual urine (PVR) compared to two previous urodynamic findings showed a less significant relationship with clinical cure rate (P = 0.04). Among the findings of muscle-nerve (MUAP Fibrillation, Positive sharp way) none of them had a significant relationship with cure rate.
  
  
  CONCLUSIONS
  Urodynamic finding, especially Qmax and bladder contractility index, can be considered as predictive indicators for patients' recovery after surgery.
authors.affiliation: Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Center of Excellent, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Mohammadreza
authors.initials: M
authors.lastname: Shahmohammadi
authors.affiliation: Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Center of Excellent, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Reza Jalil
authors.initials: RJ
authors.lastname: Khoshuod
authors.affiliation: Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Center of Excellent, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Alireza
authors.initials: A
authors.lastname: Zali
authors.affiliation: Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Center of Excellent, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Amir Saied
authors.initials: AS
authors.lastname: Seddeghi
authors.affiliation: Functional Neurosurgery Research Center, Shohada Tajrish Neurosurgical Center of Excellent, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Nima Mohseni
authors.initials: NM
authors.lastname: Kabir
keywords: Cauda equina syndrome; Electrodianosis; Urodynamic study