Assessment and early investigation of cauda equina syndrome- a systematic review of existing international guidelines and summary of the current evidence

Review written by Dr Sandy Hilton info

Key Points

  1. Cauda Equina Syndrome is an emergency needing immediate referral for correction.
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BACKGROUND & OBJECTIVE

Cauda Equina Syndrome (CES) is a clinical emergency caused by disc herniation, compression from degenerative changes, tumors, bone fragments, or from infections. An MRI is the gold standard for definitive diagnoses. Clinical signs and symptoms include bilateral radicular pain, perineal sensory disturbance, or bowel or bladder dysfunction (sudden onset of incontinence, retention, or pain) (1). Clinical screening alone is not sufficient for the diagnosis which supports the need for an urgent MRI (2).

The authors completed a systematic review on CES to create an accessible summary of current information in order to facilitate more consistent screening and timely referrals to decrease the number of missed diagnoses which lead to significant long-term burden (3).

Cauda Equina Syndrome is a clinical emergency caused by disc herniation, compression from degenerative changes, tumors, bone fragments, or from infections.
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Clinicians must screen for cauda equina syndrome, beyond standard red flag questions, we have a good tool in the Oswestry Low Back Pain Disability Questionnaire that asks about sexual dysfunction.

METHODS

In this systematic review, the authors excluded papers written before 2000 as MRI screening was not sufficiently available before 2000.

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