Abstract
Cauda equina syndrome is a potentially devastating spinal condition. The diagnosis
of cauda equina syndrome lacks sensitivity and specificity, sometimes occurring after
irreparable neurological damage has happened. Timely diagnosis and treatment is imperative
for optimal outcomes and for avoiding medicolegal ramifications. Cauda equina syndrome
results from conditions that compress the nerves in the lumbosacral spinal canal.
Although no consensus definition exists, it generally presents with varying degrees
of sensory loss, motor weakness, and bowel and bladder dysfunction (the latter of
which is required to definitively establish the diagnosis). A thorough history and
physical exam is imperative, followed by magnetic resonance or computed tomography
imaging myelogram to aid in diagnosis and treatment. Once suspected, emergent spinal
surgery referral is indicated, along with urgent decompression. Even with expeditious
surgery, improvements remain inconsistent. However, early intervention has been shown
to portend greater chance of neurologic recovery. All providers in clinical practice
must understand the severity of this condition. Providers can optimize long-term patient
outcomes and minimize the risk of litigation by open communication, good clinical
practice, thorough documentation, and expeditious care.
Keywords
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Article info
Publication history
Published online: August 30, 2021
Footnotes
Funding: None.
Conflict of Interest: None.
Authorship: All authors had access to the data and a role in writing this manuscript.
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
