If adopted widely it is less likely incomplete CES would be missed. It is a useful adjunct to conventional clinical assessment and allows risk-stratification in managing suspected CES. Use of the PVR volume ≥ 200 ml was considerably more accurate in predicting CES. Post-void residuals may serve as a helpful diagnostic adjunct in the work-up of cauda equina syndrome. There were considerable cost-savings associated with the above strategy.Ĭonclusion: This is the largest reported prospective evaluation of suspected CES. None of the latter scans showed any cauda equina compression (p < 0.006) or individuals developed subsequent CES in the intervening period. Post-void residual urinary incontinence is seen, as well as decreased anal tone. The PVR allowed risk-stratification with 13% patients deemed 'low-risk' of CES. The PVR sensitivity was 94.1%, specificity 66.8%, PPV 29.9% and NPV 98.7%. Aims: Diagnosis of cauda equina syndrome (CES) remains difficult clinical assessment has low accuracy in reliably predicting MRI compression of the cauda. Use of a PVR volume of ≥ 200 ml was a demonstrably more accurate test for predicting cauda equina compression on subsequent MRI (p < 0.001). Of note 'bilateral sciatica' had a sensitivity of 32.4%, and a positive predictive value (PPV) of only 17.2%, and negative predictive value (NPV) 88.3%. To improve patient outcomes and minimize medicolegal risk. CES is often missed on the patient’s initial visit which can lead to significant neurologic compromise in a matter of hours 1. Results: The study confirms the low predictive value of 'red flag' symptoms and signs. Cauda equina syndrome (CES), which occurs due to compression of the distal lumbar and sacral nerve roots, is a potentially devastating cause of back pain. All were assessed by Board-eligible spinal surgeons and had transabdominal ultrasound bladder scans for pre- and post-voiding residual (PVR) volume measurements before lumbosacral MRI. Methods: A total of 260 patients with suspected CES were referred to a tertiary spinal unit over a 16-month period. Cauda equina syndrome (CES) results from compression and disruption of the function of these nerves and. This prospective study tests the usefulness of ultrasound bladder scans as an adjunct for diagnosing CES. The cauda equina is a group of nerves and nerve roots stemming from the distal end of the spinal cord, typically levels L1-L5 and contains axons of nerves that give both motor and sensory innervation to the legs, bladder, anus, and perineum. Aims: Diagnosis of cauda equina syndrome (CES) remains difficult clinical assessment has low accuracy in reliably predicting MRI compression of the cauda equina (CE).
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