Complex back pain: the follow up
Research type
Research Study
Full title
Complex back pain: the follow up
IRAS ID
222024
Contact name
Anthony David
Contact email
Sponsor organisation
King's College Hospital NHS Foundation Trust
Duration of Study in the UK
0 years, 4 months, 25 days
Research summary
Cauda equina syndrome (CES) is a rare but serious neurosurgical emergency. In CES the nerves at the base of the spine become compressed and if left untreated the clinical consequences are potentially devastating. Cauda equina syndrome (CES) presents with a variable cluster of clinical symptoms; back pain coupled with bladder, bowel symptoms or numbness in the saddle area leads to a high index of suspicion and warrants emergency MR imaging of the lumbar spine.
However, a high proportion of these MRI scans detect no pathology which can account for the symptoms – previous evidence suggests up to 48% of patients undergoing scans have normal imaging. Currently little is known about this scan-negative patient group; questions remain regarding the cause of their symptoms, their clinical course on discharge from hospital and the types of treatment they receive and find beneficial. A proportion of these patients likely have symptoms which are medically unexplained and psychiatric in origin.
In an audit at Kings College Hospital, London 160 patients were identified who had a lumbar MRI for suspected CES in a 12-month period ending December 2015. In this audit 85% of scans did not show evidence of CES and information regarding their clinical presentation and demographics was collected via electronic patient records. However, in order to characterize this patient group further we would hope to gain more information from these patients regarding their quality of life and clinical course on discharge and the treatments they received. We hope to do this by contacting these patients and their GPs with a questionnaire and a follow-up telephone call. In doing so we would hope to optimise the future treatment and follow up of scan-negative patient groups and potentially improve quality of life and reduce repeat hospital attendances.
REC name
London - West London & GTAC Research Ethics Committee
REC reference
17/LO/1113
Date of REC Opinion
20 Jun 2017
REC opinion
Favourable Opinion