Surgical Outcomes of 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 functional and quality of life (QOL) outcomes in patients with cauda equina tumors using the Japanese Orthopaedic Association Back Pain Evaluation Questionnaire (JOABPEQ), and to assess whether these outcomes differ between younger and elderly patients—an issue not previously examined. Setting. Single university hospital. Methods. Sixty-five patients who underwent surgery for cauda equina tumors between 2008 and 2017 were retrospectively analyzed. Neurological function was assessed using the JOA score, and QOL was evaluated using the JOABPEQ preoperatively and at two years. Effectiveness rates for each JOABPEQ domain were calculated. Patients were categorized into younger (<65 years) and elderly (≥65 years) groups. Univariable and multivariable logistic regression analyses were performed to identify predictors of improvement. Results. Significant improvements were observed in neurological function, pain, and sensory disturbances. JOABPEQ demonstrated high effectiveness in pain-related and physical function domains, whereas mental health improvement was more limited. Effectiveness profiles were similar between age groups. Multivariable analysis identified improvement in numbness of the buttocks and lower limbs as an independent predictor of better walking ability, social life function, and mental health. Shorter disease duration was additionally associated with greater improvement in mental health. Conclusion. Surgery for cauda equina tumors yields meaningful gains in neurological function and patient-reported outcomes across age groups. Sensory recovery—particularly improved numbness—plays a central role in functional and psychological recovery, supporting the incorporation of PROMs in postoperative assessment and underscoring the value of timely intervention.