Clinical features indicative of a diagnosis of Cauda Equina Syndrome

  • Research type

    Research Study

  • Full title

    When to suspect Cauda Equina Syndrome in patients presenting to the Emergency Department with back pain

  • IRAS ID

    244694

  • Contact name

    James Ennis

  • Contact email

    j.ennis@bham.ac.uk

  • Sponsor organisation

    University of Birmingham

  • Duration of Study in the UK

    0 years, 6 months, 0 days

  • Research summary

    This research proposes to perform a review of past notes of patients who presented to the Emergency Department of Northwick Park Hospital with back pain who had an MRI scan performed of their spine to rule out compression of their lower spinal cord, a condition known as Cauda Equina Syndrome. The notes of these patients will be reviewed to see if there is any difference in presenting symptoms between those who had negative and positive MRI findings for cauda equina syndrome (CES) in order to analyse which features may be more specific to a positive diagnosis. The researchers feel that district general hospitals (DGH) without neurosurgical specialities or 24/7 MRI facilities on site are often delaying the door to treatment time of patients with suspected CES due to confusion regarding their clinical presentation and that the 'textbook' features of CES only being present in patients with bowel or bladder incontinence with sciatica in both legs no longer stands. In reviewing the presentations of those patients with MRI-positive CES over the last 2 years, the researchers hope to initiate a conversation about a review of guidelines for emergency clinicians in DGHs so that they can more confidently advocate for a group of patients with softer clinical signs who until now may have a diagnosis of CES missed or delayed with often devastating, life altering consequences.

  • REC name

    South East Scotland REC 02

  • REC reference

    18/SS/0138

  • Date of REC Opinion

    31 Oct 2018

  • REC opinion

    Favourable Opinion