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STUDY DESIGN A prospective patient' database operated on a cauda equina syndrome (CES). OBJECTIVE The aim of our study was to identify prognosis factors for favorable functional recovery after CES. SUMMARY OF BACKGROUND CES is a neurologic impairment of variable symptoms associating urinary, bowel, and sexual dysfunctions with or without motor or sensitive deficits caused by nerve root compression of the cauda equina. The definition of CES remains debated, as well as the prognosis factors for favorable functional recovery and the benefit of early surgery. METHODS One hundred and forty patients were included between January 2010 and 2019. Univariate and Multivariate cox proportional hazard regression models were conducted. RESULTS The patients were young with a median age of 46.8 years (range 18-86 years). At presentation, 60% were affected by a motor deficit, 42.8% a sensitive deficit, 70% urinary dysfunctions and 44% bowel dysfunctions. The mean FU was 15.5 months. Bilateral motor deficit (p = 0.017) and an initial deficit severity of 0-2 (p = 0.001) represented prognosis factors of poor motor recovery. Initial anal incontinence (p = 0.007) was associated with poor bowel recovery. Only 32.8% of the patients went back to work. Initial motor deficit (p = 0.015), motor sequelae (p = 0.001), sphincter dysfunctions sequelae (p = 0.02) and long LOS (p = 0.02) were poor return-to-work prognosis factors. Time to surgery within an early timing

The incidence of spinal metastasis (SpM) is increasing, and life expectancy for patients with malignancy is also rising. The "elderly" represent a population with steady growth in SpM proportion. Bracing is associated with lower survival. We believe that surgery should be considered, regardless of the patient's age.Multicentric prospective study. Through this study, we aimed to clarify and update the prognostic assessment of elderly with spine metastasis (SpM). The incidence SpM is rising, in parallel life expectancy is getting longer and the number of elderly patients presenting malignancy is increasing. Elderly patients with SpM constitute a growing heterogeneous population The patient data used in this study were obtained from a French national multicenter database of patients treated for SpM between 2014 and 2017. Two hundred and forty-three consecutive patients70 years’ old were diagnosed. Median overall survival (OS) time for elderly patients following the event of SpM was 16.3 months. First, we identified significantly worse survival prognostic factors for elderly patients with SpM: poor WHO status 3/4: (hazard ratio [HR]: 2.245, 95% confidence interval [CI] 1.899–2.655; P 0.0001),80 years (HR: 1.758, 95% CI 1.117–2.765; P = 0.015) no-ambulatory neurological status (Franckel A/B status [HR: 3.219, 95% CI 1.621–6.390; P 0.0001)], gastrointestinal cancer (HR: 3.530, 95% CI 1.75–7.1; P 0.0001), lung cancer (HR: 3.452, 95% CI 1.784–6.680; P 0.0001), orthopedic brace treatment (HR: 1.329; 95% CI 1.050–1.683; P = 0.018), and epiduritis (HR: 1.52, 95% CI 1.041–2.22; P = 0.03) were independently poor prognostic factors of survival. The only good prognosis factor identified was thyroid cancer (HR: 0.257, 95% CI 0.07–0.952; P = 0.04). Prognosis factors concerning the survival of elderly patients seem to be the same as those for the general population such as primary cancer histology, neurological status, WHO status, and epiduritis. Age80 years also appears to be an independently poor prognosis factor. Our data suggest that orthopedic brace treatment is also associated with lower survival. Level of Evidence: 2.