DOI: 10.11648/j.ijn.20261002.12 ISSN: 2640-1959

Surgical Management of Cauda Equina Syndrome Due to Disc Herniation at Brazzaville University Hospital (2022-2025): About 16 Cases

Leon Boukassa, Roland Banga-Mouss, Sinclair Bambino, Norbert Lamini, Rel Kala, Olivier Olivier, Daphtone Kidede, Hugues Mbaki
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Introduction : Cauda equina syndrome (CES) is a dreaded complication of lumbar disc herniations, requiring rapid surgical management. The few studies conducted in low-income countries note a failure to meet this requirement. We conducted this study to describe the management of patients operated on for this condition in the neurosurgery department of the Brazzaville University Hospital. Methods : This was a retrospective descriptive study conducted between January 2022 and December 2025, involving 16 patients operated on for CES due to disc herniation, confirmed by imaging (CT or MRI). Pre- and postoperative severity was assessed using the SSCES (Scoring System for Cauda Equina Syndrome). Patients were followed up at 1 month, 3 months, and 6 months. Results : The mean age was 48.2 years (range 39-68), with a sex ratio (M/F) of 3. Patients were seen on average 14.7 days (range 7-21) after the onset of signs. CES was complete in 56.2% and incomplete in 43.7%. Disc herniation was located at L4-L5 in 50%, L3-L4 and L5-S1 in 18.7% each, and L2-L3 in 12.5%. Discectomy was performed after laminectomy in 56.2% of patients. Patient outcomes were satisfactory, with the number of patients having an excellent or good SSCES score increasing from 2 preoperatively to 13 patients at the 6th postoperative month. Conclusion : The management of CES due to disc herniation at Brazzaville University Hospital is marked by diagnostic and therapeutic delays which impact neurological recovery. It is therefore important to raise awareness among healthcare providers and enable rapid patient access to imaging and surgery.

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