This week we discuss the difficult to diagnose and high morbidity cauda equina syndrome.



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Tags: Back Pain, Cauda Equina





Show Notes
Take Home Points

Cauda equina syndrome is a rare emergency with devastating consequences
Early recognition is paramount as the presence of bladder dysfunction portends bad functional outcomes
The presence of bilateral lower extremity weakness or sensory changes should alert clinicians to the diagnosis. Saddle anesthesia (or change in sensation) and any bladder/bowel changes in function should also raise suspicion for the disorder
MRI is the diagnostic modality of choice though CT myelogram can be performed if necessary
Prompt surgical consultation is mandatory for all patients with cauda equina syndrome regardless of symptoms at presentation

Read More
EM Cases: Best Case Ever 11: Cauda Equina Syndrome
OrthoBullets: Cauda Equina Syndrome
Radiopaedia: Cauda Equina Syndrome
Perron AD, Huff JS: Spinal Cord Disorders, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2010, (Ch) 106: p 1419-30.
References
Lavy C et al. Cauda Equina Syndrome. BMJ 2009; 338: PMID: 19336488
Todd NV. Cauda equina syndrome: the timing of surgery probably does influence outcome. Br J Neurosurg 2005;19:301-6 PMID: 16455534


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