Diagnosis of cauda equina syndrome in the emergency department

Metcalfe, David
Hoeritzauer, Ingrid
Angus, Michelle
Novak, Alex
Hutton, Mike
Woodfield, Julie

¹ Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford, UK
² Emergency Medicine Research in Oxford (EMROx), Oxford University Hospitals NHS Foundation Trust, Oxford, UK
³ Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
⁴ Department of Clinical Neurosciences, Edinburgh Royal Infirmary, Edinburgh, UK
⁵ Complex Spinal Department, Salford Royal NHS Foundation Trust, Salford, UK
⁶ Exeter Spinal Surgery Unit, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK

Dr David Metcalfe, Nuffield Department of Orthopaedics, Rheumatology, and Musculoskeletal Sciences (NDORMS), University of Oxford, Oxford OX3 9DU, UK; [email protected]

Received February 10, 2023

Accepted August 22, 2023

Emergency Medicine Journal 40(11):p 787-793, November 2023. | DOI: 10.1136/emermed-2023-213151

Cauda equina syndrome (CES) is a spinal emergency that can be challenging to identify from among the many patients presenting to EDs with low back and/or radicular leg pain. This article presents a practical guide to the assessment and early management of patients with suspected CES as well as an up-to-date review of the most important studies in this area that should inform clinical practice in the ED.