Publication

[Emergency scenario: cauda equina syndrome--assessment and management]

Journal Paper/Review - Mar 19, 2008

Units
PubMed

Citation
Gautschi O, Cadosch D, Hildebrandt G. [Emergency scenario: cauda equina syndrome--assessment and management]. Praxis 2008; 97:305-12.
Type
Journal Paper/Review (Deutsch)
Journal
Praxis 2008; 97
Publication Date
Mar 19, 2008
Issn Print
1661-8157
Pages
305-12
Brief description/objective

Acute low back pain is one of the most frequent reason for an emergency or primary care physician visit. Up to 90% of all adults will experience an episode of back pain at some point during their lifetime. Although the majority of patients have uncomplicated benign presentation and 80-90% recover within 4 to 6 weeks, there is a small subset who has an underlying potential life-threatening etiology. Among them are aortic dissection, ruptured abdominal aortic aneurysm, vertebral osteomyelitis, spinal epidural abscess and the cauda equina syndrome (CES). The latter entails a compression of the nerve roots of the cauda equina. These patients usually present post-traumatically with the clinical triad of saddle anesthesia, bowel or bladder dysfunction and muscular weakness of the lower extremeties. A delayed diagnosis can result in a significantly increased morbidity. Therefore, early diagnosis and the initiation of the appropriate therapeutic steps are essential. A thourough anamnesis and physical examination are leading to the suspected diagosis. Below, clinical presentation, diagnosis and relevant treatment of the CES are discussed.