title: Standards of care in cauda equina syndrome.
abstract: What constitutes cauda equina syndrome (CES), how it should be subclassified and how urgently to image and operate on patients with CES are all matters of debate. A structured review of the literature has led us to evaluate the science and to propose evidence-based guidelines for the management of CES. Our conclusions include this guidance: pain only; MRI negative - recommend: analgesia, ensure imaging complete (not just lumbar spine) adequate follow-up. Bilateral radiculopathy (CESS) with a large central disc prolapse - recommend: discuss with the patient and if for surgery, the next day (unless deteriorates to CESI in which case emergency surgery); CESI - recommend: the true emergency for surgery by day or night; a large central PLID with uncertainty as to whether CESI or CESR (e.g. catheterised prior to CESR) or where there is residual cauda equina nerve root function or early CESR - recommend: treat as an emergency by day or night. Where there has been prolonged CESR and/or no residual sacral nerve root function - recommend: treat on the following day's list.
authors.affiliation: a Sandyford , Newcastle upon Tyne , UK ;
authors.forename: N V
authors.initials: NV
authors.lastname: Todd
authors.affiliation: b University of Leeds , Leeds , UK.
authors.forename: R A
authors.initials: RA
authors.lastname: Dickson
mesh_terms: D019468:Disease Management; D019317:Evidence-Based Medicine; D017408:Guidelines as Topic; D006801:Humans; D011128:Polyradiculopathy / Q000601:surgery / Q000628:therapy*; D059039:Standard of Care
keywords: CES; CESC; CESI; CESR; CESS; Cauda equina syndrome; standards of care