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- Issue 11
- ASSESSMENT AND MANAGEMENT OF CAUDA EQUINA…
ASSESSMENT AND MANAGEMENT OF CAUDA EQUINA SYNDROME
BACKGROUND & OBJECTIVE
Cauda Equina Syndrome (CES) has inherently negative and lifechanging consequences for patients who experience a delay in diagnosis. Bladder and bowel issues including urinary retention, urinary/faecal incontinence, sexual dysfunction and pain are accompanied by the psychosocial impact of these issues. This clinically focused review paper examines the current evidence and provides a clinically reasoned approach to CES management.
METHODS
A clinical reasoning approach was applied to an examination of the CES evidence base by 4 consultant level UK musculoskeletal physiotherapists.
The importance of the clinical interaction between patient and therapist is highlighted. Sensitive and thorough questioning and examination are paramount.
RESULTS
Red flags are currently used to aid in the recognition of CES, however the evidence base strongly suggests that they are not good predictors of pathology and fail to meet best standards of practice. Instead, the importance of the clinical