Aim: This project explored how the implementation of national guidance for investigation and management of patients with suspected cauda equina syndrome impacted on service provision.
Methods: Retrospective analysis of patients with suspected cauda equina syndrome during 12 months before the implementation of the national guidelines were compared with data from the 21 months following.
Results: Monthly mean numbers of referrals for suspected cauda equina syndrome increased from 10.1 to 18.9 (<0.001). Statistically significant increases were also seen in the total number of magnetic resonance imaging scans for suspected cauda equina syndrome, and the number of magnetic resonance imaging scans performed out of hours. The mean time interval, from magnetic resonance imaging scan confirming cauda equina syndrome to starting emergency decompressive surgery, reduced from 14.87 hours to 9.57 hours.
Conclusions: Compliance with the national guidance for suspected cauda equina syndrome is imperative for patients to receive optimal treatment. However, this project has demonstrated challenges related to increased pressure on resources.
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http://dx.doi.org/10.12968/hmed.2021.0040 | DOI Listing |
Clin Case Rep
January 2025
Pediatric Neurology Department, Pediatric Neurology Research Center Shahid Beheshti University of Medical Sciences Tehran Iran.
Intrathecal methotrexate can cause cauda equina syndrome in pediatric ALL patients, as demonstrated in this rare case of an 8-year-old boy. Symptoms included progressive limb weakness and urinary retention. Early recognition, prompt discontinuation of the offending agent, and multidisciplinary management are crucial.
View Article and Find Full Text PDFNeurosurg Rev
January 2025
Department of Neurosurgery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
This study aims to thoroughly investigate the clinical presentation, duration of symptoms, radiological aspects of posterior epidural migration of disc fragments (PEMDF), and assess various treatment options and their impacts on patient functionality. A systematic review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. We conducted a comprehensive search in PubMed, Web of Science, and Scopus from inception to March 2024.
View Article and Find Full Text PDFActa Vet Scand
January 2025
Department of Companion Animal Clinical Sciences, Faculty of Veterinary Medicine, Norwegian University of Life Sciences, Oluf Thesens Vei 30, Ås, Norway.
Background: A lumbosacral transitional vertebra (LTV) is a congenital anomaly of the caudal vertebral column. It has been associated with asymmetrical canine hip dysplasia (CHD) and cauda equina syndrome (CES) in German Shepherd dogs. This retrospective cross-sectional study aims to report the potential influence of asymmetric LTV on pelvic anatomy using ventrodorsal (VD) radiographs.
View Article and Find Full Text PDFOrthop Surg
January 2025
Department of Orthopedics, Ningbo No. 6 Hospital, Ningbo, Zhejiang, China.
Background: Postoperative spinal epidural hematoma (SEH) is a rare but serious complication following lumbar surgery, with cauda equina syndrome (CES) being one of its most devastating outcomes. While CES typically presents with a combination of bladder and/or bowel dysfunction, diminished sensation in the saddle area, and motor or sensory changes in the lower limbs, atypical cases with isolated urinary symptoms are less recognized and pose significant diagnostic challenges.
Case Presentation: We report the case of a 46-year-old male who developed CES following lumbar microdiscectomy, presenting solely with urinary retention, without the classic signs of lower limb weakness or perineal sensory loss.
BMC Musculoskelet Disord
January 2025
Chinese People's Armed Police Force Special Medical Center, Tianjin, 300300, China.
Background: Lumbar burst fracture combined with lamina fracture is a special type of spinal fracture. Neither CT nor MRI can accurately determine it. The present study aims to investigate the clinical value of 3D CT/MRI fusion imaging in the treatment of lumbar burst fracture complicated with lamina fracture.
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