[Emergency scenario: cauda equina syndrome--assessment and management].
Acute low back pain is one of the most frequent reason for an emergency or primary care physician visit. Up to 90% of all adults will experience an episode of back pain at some point during their lifetime. Although the majority of patients have uncomplicated benign presentation and 80-90% recover within 4 to 6 weeks, there is a small subset who has an underlying potential life-threatening etiology. Among them are aortic dissection, ruptured abdominal aortic aneurysm, vertebral osteomyelitis, spinal epidural abscess and the cauda equina syndrome (CES). The latter entails a compression of the nerve roots of the cauda equina. These patients usually present post-traumatically with the clinical triad of saddle anesthesia, bowel or bladder dysfunction and muscular weakness of the lower extremeties. A delayed diagnosis can result in a significantly increased morbidity. Therefore, early diagnosis and the initiation of the appropriate therapeutic steps are essential. A thourough anamnesis and physical examination are leading to the suspected diagosis. Below, clinical presentation, diagnosis and relevant treatment of the CES are discussed.
Gautschi
O P
OP
Klinik für Neurochirurgie, Kantonsspital St. Gallen, St. Gallen. Oliver.Gautschi@kssg.ch
Cadosch
D
D
Hildebrandt
G
G
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D001416:Back Pain / Q000209:etiology*; D003131:Combined Modality Therapy; D019299:Decompression, Surgical; D017586:Diskectomy; D004630:Emergencies; D006801:Humans; D007796:Laminectomy; D008159:Lumbar Vertebrae / Q000601:surgery; D008279:Magnetic Resonance Imaging; D009408:Nerve Compression Syndromes / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D009460:Neurologic Examination; D011128:Polyradiculopathy / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D011379:Prognosis; D012307:Risk Factors; D012447:Sacrum / Q000601:surgery; D013126:Spinal Nerve Roots / Q000601:surgery
D000305:Adrenal Cortex Hormones