title: British Association of Spine Surgeons standards of care for cauda equina syndrome.
abstract: This group of articles looks at the BASS guidelines for CES. TG and AC gave us the background on the long journey taken in publishing this, SA summarized the forum discussion on the BASS Web site, and NT gave us a medicolegal comment. The guidelines are concise, highlighting the need for prompt MRI scanning and as a consequence emergency surgery in appropriate cases. This has resource implication in terms of MRI availability and a comprehensive spinal on-call system. The question of whether operating "in the small hours" carries increased risk or whether we are using this as an excuse not to get out of bed needs to be addressed. CES discs tend to be more difficult than standard ones and probably associated with a higher complication rate. Literature on complications from night-time trauma surgery has considerably reduced out-of-hour operating in trauma. Guidelines on CES will allow the spinal community to prospectively collect data on a national registry which in time will allow us to further improve our understanding and treatment of this condition. Spinal surgery is quickly evolving into a separate specialty. These guidelines further highlight the need for a single spinal society to help set standards, educate, and revalidate our members. It is important that we all engage in this debate to get a consensus opinion to improve spinal practice across the United Kingdom.
authors.affiliation: BASS Past President, Consultant Neurosurgeon-Derriford Hospital, Plymouth, UK.
authors.forename: Timothy
authors.initials: T
authors.lastname: Germon
authors.affiliation: Consultant Orthopaedic Spinal Surgeon-University Hospital of Wales & University Hospital Llandough, Cardiff, UK. Electronic address: sashinahuja@gmail.com.
authors.forename: Sashin
authors.initials: S
authors.lastname: Ahuja
authors.affiliation: BASS President, Consultant Neurosurgeon-The National Hospital for Neurology & Neurosurgery, Queen Square (UCLH) & The Royal National Orthopaedic Hospital Stanmore, London, UK.
authors.forename: Adrian T H
authors.initials: ATH
authors.lastname: Casey
authors.affiliation: Consultant Neurosurgeon-Newcastle General Hospital, Newcastle Upon Tyne, UK.
authors.forename: Nicholas V
authors.initials: NV
authors.lastname: Todd
authors.affiliation: BASS President Elect, Consultant Orthopaedic Spinal Surgeon-Norfolk & Norwich University Hospital, Norwich, UK.
authors.forename: Am
authors.initials: A
authors.lastname: Rai
mesh_terms: D032921:Consensus; D019299:Decompression, Surgical / Q000592:standards*; D006801:Humans; D011128:Polyradiculopathy / Q000175:diagnosis / Q000601:surgery*; D013131:Spine / Q000601:surgery*; D059039:Standard of Care