Cauda equina syndrome is the clinical syndrome seen when there is acute compression of the cauda equina nerve roots and is a rare neurosurgical emergency. This Element presents up-to-date evidence-based and pragmatic interpretation of the UK guidance on investigating and managing cauda equina syndrome.
Cauda equina syndrome is the clinical syndrome seen when there is acute compression of the cauda equina nerve roots and is a rare neurosurgical emergency. The approximate incidence in patients presenting with low back pain is 0.27% but delays in investigation and treatment can result in life-changing permanent disability. The best practice for patients presenting with potential cauda equina syndrome is urgent MRI imaging at the presenting hospital to avoid delays in diagnosis. Patients with a positive finding of cauda equina compression should proceed to decompressive surgery to restore the diameter of the spinal canal urgently to reduce the risk of developing a permanent deficit.
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