Surgical outcomes and age-related differences in cauda equina tumors assessed by patient-reported outcome measures using the Japanese orthopaedic association back pain evaluation questionnaire.

STUDY

DESIGN

Single-institution retrospective study.

OBJECTIVES

To evaluate postoperative neurological and QOL outcomes in patients with cauda equina tumors using JOABPEQ, and to investigate age-related differences in postoperative recovery, which remain poorly understood in this population.

SETTING

Single university hospital.

METHODS

Sixty-five patients who underwent surgery for cauda equina tumors from 2008-2017 were retrospectively analyzed. Neurological function was assessed using the JOA score, and QOL was evaluated using JOABPEQ before surgery and at two years postoperatively. Pain and sensory symptoms were assessed using VAS scores. Patients were categorized into elderly (≥65 years) and non-elderly (<65 years) groups. General linear models and multivariable logistic regression analyses were performed.

RESULTS

Significant postoperative improvements were observed in JOA score, VAS scores, and all JOABPEQ domains. JOABPEQ demonstrated relatively high effectiveness rates in pain-related and physical function domains, whereas mental health showed the lowest effectiveness rate. Improvement in lower-limb numbness was independently associated with better recovery in walking ability, social life function, and mental health. Elderly patients showed worse preoperative neurological and pain-related symptoms; however, postoperative outcomes and JOABPEQ effectiveness rates were comparable between elderly and non-elderly patients after adjustment for cardiovascular disease and baseline severity.

CONCLUSION

Surgical treatment for cauda equina tumors resulted in significant improvements in neurological function, pain, and QOL. Despite worse preoperative symptoms, elderly patients achieved postoperative outcomes comparable to those of non-elderly patients after adjustment for baseline factors. These findings support the usefulness of PROM-based evaluation in patients with cauda equina tumors.