Lower Urinary Tract Symptoms and Urinary Bother Are Common in Patients Undergoing Elective Cervical Spine Surgery

Clin Orthop Relat Res, 2019 · DOI: 10.1097/CORR.0000000000000666 · Published: March 4, 2019

Simple Explanation

This study investigates lower urinary tract symptoms (LUTS) and urinary bother in patients undergoing elective cervical spine surgery. The researchers aimed to determine how common these symptoms are and if they are related to myelopathy (spinal cord compression) or MRI findings. The study found that a significant number of patients had moderate-to-severe LUTS, and those with myelopathy were more likely to experience these symptoms.

Study Duration

Approximately 30-month period

Participants

242 adult patients undergoing elective cervical spine surgery

Evidence Level

Level III, prognostic study

Key Findings

1
Nearly half of all patients undergoing elective cervical spine surgery had moderate-to-severe LUTS.
2
The prevalence of clinically relevant urinary bother was higher in patients with myelopathy compared to those without.
3
There was no association between spinal cord compression, as diagnosed on MRI, and LUTS in patients with myelopathy.

Research Summary

This study found that lower urinary tract symptoms (LUTS) are common in patients undergoing elective cervical spine surgery, with nearly half reporting moderate to severe symptoms. Patients with myelopathy reported LUTS and urinary bother more frequently than those without, even after adjusting for age and sex. The study emphasizes the importance of provider awareness regarding the high prevalence of LUTS in this patient population to avoid unnecessary imaging and potential surgical complications.

Practical Implications

Increased Provider Awareness

Healthcare providers should be aware of the high prevalence of LUTS in patients undergoing cervical spine surgery.

Differential Diagnosis

Urinary symptoms should not automatically be considered 'red flags' for cauda equina syndrome, potentially preventing unnecessary interventions.

Preoperative Assessment

Consider assessing patients for LUTS preoperatively to manage expectations and potentially mitigate postoperative complications.

Study Limitations

1
LUTS were determined by patient self-evaluation via questionnaire.
2
The study did not grade the severity of myelopathy or calculate the Japanese Orthopaedic Association (JOA) score.
3
Data were collected from a sample of patients at a single institution, which may decrease the generalizability of the results.

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