The suspected cauda equina syndrome score (SuCESS): development and validation of a clinical triage tool

Key Points

1. Current guidelines continue to recommend urgent MRI for people with suspected cauda equina syndrome (CES).

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BACKGROUND & OBJECTIVE

Cauda equina syndrome (CES) is a relatively rare, poorly defined condition characterized by a cluster of symptoms that may be present in other conditions. Emergency magnetic resonance imaging (MRI) is mandated for suspected cases of CES, as a delay in diagnosis and treatment when CES is present may result in irreversible disability.

The aim of this retrospective analysis was to develop and validate the Suspected Cauda Equina Syndrome Score (SuCESS), a clinical triage tool to safely exclude CES and improve triage accuracy.

Cauda equina syndrome (CES) is a relatively rare, poorly defined condition characterized by a cluster of symptoms that may be present in other conditions.

The SuCESS tool gives a point value to the red flags commonly associated with CES, helping clinicians identify a threshold when CES is more likely, without missing or minimizing signs or symptoms.

METHODS

• The SuCESS triage tool was developed and validated over four cohorts, from 2016 to 2023. This retrospective, multivariable diagnostic model derivation and temporal validation study was based on data from patients referred to a tertiary spinal unit in the United

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