{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T20:24:59Z","timestamp":1789244699776,"version":"build-2803163510"},"reference-count":22,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2025,4,2]],"date-time":"2025-04-02T00:00:00Z","timestamp":1743552000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Spine J"],"published-print":{"date-parts":[[2026,4]]},"DOI":"10.1007\/s00586-025-08816-x","type":"journal-article","created":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T02:26:54Z","timestamp":1743733614000},"page":"1715-1722","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["The impact of prolapse to canal ratio (PCR) in cauda equina syndrome outcomes and operative management"],"prefix":"10.1007","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4177-9615","authenticated-orcid":false,"given":"Asfand","family":"Baig Mirza","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-0103-9500","authenticated-orcid":false,"given":"Feras","family":"Fayez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sami","family":"Rashed","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ammal Bibi","family":"Shahid","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chaitanya","family":"Sharma","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rishabh","family":"Suvarna","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amisha","family":"Vastani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed","family":"Serag","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Nader-Sepahi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexander","family":"Montgomery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irfan","family":"Malik","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gordan","family":"Grahovac","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Babak","family":"Arvin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed-Ramadan","family":"Sadek","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,4,2]]},"reference":[{"issue":"6","key":"8816_CR1","doi-asserted-by":"publisher","first-page":"460","DOI":"10.1159\/000527727","volume":"56","author":"J Woodfield","year":"2023","unstructured":"Woodfield J, Lammy S, Jamjoom AAB et al (2023) Demographics of cauda equina syndrome: A Population-Based incidence study. Neuroepidemiology 56(6):460\u2013468. https:\/\/doi.org\/10.1159\/000527727","journal-title":"Neuroepidemiology"},{"issue":"4","key":"8816_CR2","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1515\/folmed-2017-0038","volume":"59","author":"S Kapetanakis","year":"2017","unstructured":"Kapetanakis S, Chaniotakis C, Kazakos C, Papathanasiou JV (2017) Cauda equina syndrome due to lumbar disc herniation. Rev Lit Folia Med Plovdiv 59(4):377\u2013386. https:\/\/doi.org\/10.1515\/folmed-2017-0038","journal-title":"Rev Lit Folia Med Plovdiv"},{"issue":"2","key":"8816_CR3","doi-asserted-by":"publisher","first-page":"165","DOI":"10.1007\/s00264-021-05273-1","volume":"46","author":"C Lavy","year":"2022","unstructured":"Lavy C, Marks P, Dangas K, Todd N (2022) Cauda equina syndrome\u2014a practical guide to definition and classification. Int Orthop 46(2):165\u2013169. https:\/\/doi.org\/10.1007\/s00264-021-05273-1","journal-title":"Int Orthop"},{"issue":"4","key":"8816_CR4","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1055\/s-0031-1274754","volume":"2","author":"J Fairbank","year":"2011","unstructured":"Fairbank J, Hashimoto R, Dailey A, Patel AA, Dettori J (2011) Does patient history and physical examination predict MRI proven cauda equina syndrome? Evid Based Spine Care J 2(4):27\u201333. https:\/\/doi.org\/10.1055\/s-0031-1274754","journal-title":"Evid Based Spine Care J"},{"issue":"4","key":"8816_CR5","doi-asserted-by":"publisher","first-page":"383","DOI":"10.3109\/02688697.2010.505987","volume":"24","author":"K Balasubramanian","year":"2010","unstructured":"Balasubramanian K, Kalsi P, Greenough CG, Kuskoor Seetharam MP (2010) Reliability of clinical assessment in diagnosing cauda equina syndrome. Br J Neurosurg 24(4):383\u2013386. https:\/\/doi.org\/10.3109\/02688697.2010.505987","journal-title":"Br J Neurosurg"},{"key":"8816_CR6","doi-asserted-by":"publisher","unstructured":"Butenschoen VM, Abulhala S, Meyer B, Gempt J (2021) Body mass index has an impact on preoperative symptoms but not clinical outcome in acute cauda equina syndrome. Sci Rep.;2021;11(1):13918. https:\/\/doi.org\/10.1038\/s41598-021-92969-4","DOI":"10.1038\/s41598-021-92969-4"},{"issue":"3","key":"8816_CR7","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1016\/j.spinee.2017.07.177","volume":"18","author":"D Cushnie","year":"2018","unstructured":"Cushnie D, Urquhart JC, Gurr KR, Siddiqi F, Bailey CS (2018) Obesity and spinal epidural lipomatosis in cauda equina syndrome. Spine J 18(3):407\u2013413. https:\/\/doi.org\/10.1016\/j.spinee.2017.07.177","journal-title":"Spine J"},{"key":"8816_CR8","doi-asserted-by":"publisher","first-page":"e600","DOI":"10.1016\/j.wneu.2020.05.260","volume":"141","author":"R Kaiser","year":"2020","unstructured":"Kaiser R, Krajcov\u00e1 A, Waldauf P, Srikandarajah N, Makel M, Bene\u0161 V (2020) Are there any risk factors associated with the presence of cauda equina syndrome in symptomatic lumbar disk herniation?? World Neurosurg 141:e600\u2013e605. https:\/\/doi.org\/10.1016\/j.wneu.2020.05.260","journal-title":"World Neurosurg"},{"issue":"11","key":"8816_CR9","doi-asserted-by":"publisher","first-page":"1551","DOI":"10.1302\/0301-620X.94B11.29652","volume":"94","author":"M Venkatesan","year":"2012","unstructured":"Venkatesan M, Uzoigwe CE, Perianayagam G, Braybrooke N JR (2012) Is cauda equina syndrome linked with obesity? J Bone Jt Surg Br 94(11):1551\u20131556. https:\/\/doi.org\/10.1302\/0301-620X.94B11.29652","journal-title":"J Bone Jt Surg Br"},{"issue":"12","key":"8816_CR10","first-page":"8875","volume":"7","author":"L Shen","year":"2014","unstructured":"Shen L, Fang L, Qiu Y (2014) Study on different surgical approaches for acute lumber disk protrusion combined with cauda equina syndrome. Int J Clin Exp Pathol 7(12):8875\u20138880","journal-title":"Int J Clin Exp Pathol"},{"issue":"11","key":"8816_CR11","doi-asserted-by":"publisher","first-page":"1964","DOI":"10.1016\/j.apmr.2009.03.021","volume":"90","author":"S Fraser","year":"2009","unstructured":"Fraser S, Roberts L, Murphy E (2009) Cauda equina syndrome: a literature review of its definition and clinical presentation. Arch Phys Med Rehabil 90(11):1964\u20131968. https:\/\/doi.org\/10.1016\/j.apmr.2009.03.021","journal-title":"Arch Phys Med Rehabil"},{"issue":"4","key":"8816_CR12","doi-asserted-by":"publisher","first-page":"325","DOI":"10.1080\/0268869021000032887","volume":"16","author":"MJR Gleave","year":"2002","unstructured":"Gleave MJR (2002) Cauda equina syndrome: what is the relationship between timing of surgery and outcome? Br J Neurosurg 16(4):325\u2013328. https:\/\/doi.org\/10.1080\/0268869021000032887","journal-title":"Br J Neurosurg"},{"issue":"3","key":"8816_CR13","doi-asserted-by":"publisher","first-page":"391","DOI":"10.3109\/17453674.2010.483985","volume":"81","author":"J Shi","year":"2010","unstructured":"Shi J, Jia L, Yuan W et al (2010) Clinical classification of cauda equina syndrome for proper treatment. Acta Orthop 81(3):391\u2013395. https:\/\/doi.org\/10.3109\/17453674.2010.483985","journal-title":"Acta Orthop"},{"issue":"17","key":"8816_CR14","doi-asserted-by":"publisher","first-page":"1238","DOI":"10.1097\/BRS.0000000000003045","volume":"44","author":"S Pronin","year":"2019","unstructured":"Pronin S, Koh CH, Bulovaite E, Macleod MR, Statham PF (2019) Compressive pressure versus time in cauda equina syndrome: A systematic review and Meta-Analysis of experimental studies. Spine Phila Pa 1976 44(17):1238\u20131247. https:\/\/doi.org\/10.1097\/BRS.0000000000003045","journal-title":"Spine Phila Pa 1976"},{"key":"8816_CR15","doi-asserted-by":"publisher","unstructured":"Srikandarajah N, Wilby M, Clark S, Noble A, Williamson P, Marson T (2018) Outcomes Reported After Surgery for Cauda Equina Syndrome: A Systematic Literature Review. Syst Lit Rev Spine Phila.;2018;43(17):E1005-E1013. https:\/\/doi.org\/10.1097\/BRS.0000000000002605","DOI":"10.1097\/BRS.0000000000002605"},{"issue":"7","key":"8816_CR16","doi-asserted-by":"publisher","first-page":"1333","DOI":"10.1002\/nau.21176","volume":"30","author":"J Fukui","year":"2011","unstructured":"Fukui J, Ohotsuka K, Asagai Y (2011) Improved symptoms and lifestyle more than 20 years after untethering surgery for primary tethered cord syndrome. Neurourol Urodyn 30(7):1333\u20131337. https:\/\/doi.org\/10.1002\/nau.21176","journal-title":"Neurourol Urodyn"},{"issue":"6","key":"8816_CR17","doi-asserted-by":"publisher","first-page":"1193","DOI":"10.1093\/neuros\/nyx607","volume":"83","author":"R Kaiser","year":"2018","unstructured":"Kaiser R, Nasto LA, Venkatesan M (2018) Time factor and disc herniation size: are they really predictive for outcome of urinary dysfunction in patients with cauda equina syndrome?? Neurosurgery 83(6):1193\u20131200. https:\/\/doi.org\/10.1093\/neuros\/nyx607","journal-title":"Neurosurgery"},{"issue":"5","key":"8816_CR18","doi-asserted-by":"publisher","first-page":"690","DOI":"10.1007\/s00586-010-1668-3","volume":"20","author":"A Gardner","year":"2011","unstructured":"Gardner A, Gardner E, Morley T (2011) Cauda equina syndrome: a review of the current clinical and medico-legal position. Eur Spine J 20(5):690\u2013697. https:\/\/doi.org\/10.1007\/s00586-010-1668-3","journal-title":"Eur Spine J"},{"key":"8816_CR19","doi-asserted-by":"publisher","first-page":"e208","DOI":"10.1016\/j.wneu.2021.12.028","volume":"159","author":"A Baig Mirza","year":"2022","unstructured":"Baig Mirza A, Velicu MA, Lyon R et al (2022) Is cauda equina surgery safe Out-of-Hours? A single united Kingdom Institute experience. World Neurosurg 159:e208\u2013e220. https:\/\/doi.org\/10.1016\/j.wneu.2021.12.028","journal-title":"World Neurosurg"},{"key":"8816_CR20","doi-asserted-by":"publisher","unstructured":"Khashan M, Ofir D, Grundshtein A (2022) Minimally invasive discectomy versus open laminectomy and discectomy for the treatment of cauda equina syndrome: A preliminary study and case series. Front Surg 9(1031919). https:\/\/doi.org\/10.3389\/fsurg.2022.1031919","DOI":"10.3389\/fsurg.2022.1031919"},{"issue":"4","key":"8816_CR21","doi-asserted-by":"publisher","first-page":"353","DOI":"10.1089\/hs.2020.0126","volume":"19","author":"P Carter","year":"2021","unstructured":"Carter P, Megnin-Viggars O, Rubin GJ (2021) What factors influence symptom reporting and access to healthcare during an emerging infectious disease outbreak?? Health Secur 19(4):353\u2013363. https:\/\/doi.org\/10.1089\/hs.2020.0126","journal-title":"Health Secur"},{"issue":"7","key":"8816_CR22","doi-asserted-by":"publisher","first-page":"1336","DOI":"10.1111\/ene.14182","volume":"27","author":"LL Gibson","year":"2020","unstructured":"Gibson LL, Harborow L, Nicholson T, Bell D, David AS (2020) Is scan-negative cauda equina syndrome a functional neurological disorder? A pilot study. Eur J Neurol 27(7):1336\u20131342. https:\/\/doi.org\/10.1111\/ene.14182","journal-title":"Eur J Neurol"}],"container-title":["European Spine Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-025-08816-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s00586-025-08816-x","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s00586-025-08816-x.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T10:51:58Z","timestamp":1777632718000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s00586-025-08816-x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,2]]},"references-count":22,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2026,4]]}},"alternative-id":["8816"],"URL":"https:\/\/doi.org\/10.1007\/s00586-025-08816-x","relation":{},"ISSN":["0940-6719","1432-0932"],"issn-type":[{"value":"0940-6719","type":"print"},{"value":"1432-0932","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,4,2]]},"assertion":[{"value":"2 September 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 February 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"22 March 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 April 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"This study did not involve human participants or animals, and therefore, approval from an ethics committee was not required.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"As this study did not involve human participants, obtaining informed consent was not applicable.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Nil.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Previous presentations"}},{"value":"The study did not involve animals, so no statement on animal welfare is necessary. This disclosure statement confirms that there are no relevant interests, funding sources, or ethical concerns related to this research.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statement on welfare of animals"}},{"value":"The authors have no financial or non-financial interests that could be perceived as a conflict of interest or as having influenced the research reported in this article.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}}]}}