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Evaluation and Management of Cauda Equina Syndrome.
- Source :
-
The American journal of medicine [Am J Med] 2021 Dec; Vol. 134 (12), pp. 1483-1489. Date of Electronic Publication: 2021 Aug 30. - Publication Year :
- 2021
-
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.<br /> (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Subjects :
- Cauda Equina Syndrome etiology
Disease Management
Epidural Abscess complications
Epidural Abscess diagnosis
Epidural Abscess surgery
Hematoma, Epidural, Spinal complications
Hematoma, Epidural, Spinal diagnosis
Hematoma, Epidural, Spinal surgery
Humans
Intervertebral Disc Displacement complications
Intervertebral Disc Displacement diagnosis
Intervertebral Disc Displacement surgery
Lumbar Vertebrae diagnostic imaging
Lumbar Vertebrae surgery
Magnetic Resonance Imaging
Myelography
Spinal Injuries complications
Spinal Injuries diagnosis
Spinal Injuries surgery
Spinal Neoplasms complications
Spinal Neoplasms diagnosis
Spinal Neoplasms surgery
Spinal Stenosis complications
Spinal Stenosis diagnosis
Spinal Stenosis surgery
Spondylolisthesis complications
Spondylolisthesis diagnosis
Spondylolisthesis surgery
Tomography, X-Ray Computed
Cauda Equina Syndrome diagnosis
Cauda Equina Syndrome surgery
Decompression, Surgical
Neurologic Examination
Subjects
Details
- Language :
- English
- ISSN :
- 1555-7162
- Volume :
- 134
- Issue :
- 12
- Database :
- MEDLINE
- Journal :
- The American journal of medicine
- Publication Type :
- Academic Journal
- Accession number :
- 34473966
- Full Text :
- https://doi.org/10.1016/j.amjmed.2021.07.021