New standards of care for cauda equina syndrome
Lower back pain is common and cauda equina syndrome (CES) is rare, but the consequences can be devastating. Young people can be left with lifelong incontinence and paraplegia if surgery is delayed or the diagnosis is missed.
The best initial investigation is of course an MRI, but these are expensive and difficult to get in many hospitals, especially out-of-hours. From an EM perspective, a suspected case of CES often involves protracted discussions with radiology, orthopaedics and neurosurgery and can be something of a challenge.
If only there were a set of nationally-agreed standards detailing which patients require an MRI and which of these need urgent surgery...
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