Scholarlink

Introduction <p>Cauda Equina Syndrome (CES) is a surgical emergency and an intimidating medico-legal challenge. Poor clinical specificity leads to a high rate of negative (normal/<i>No-CES</i>) MRI scans, placing additional burden on emergency services. A proportion of patients re-present with CES-like symptoms. The aim of this study was to assess this cohort of patients and identify the incidence, clinical risk factors, comparative MRI-findings and predictive factors for subsequent True-CES.</p> Methods <p>Retrospective review of prospective data of patients aged 18–65 years, who first attended with suspected-CES with a normal MRI, between January 2019-December 2022; and re-presented with suspected-CES within one year. Patients with True-CES or abnormal MRI pathology at first attendance were excluded. Clinical, bladder scan and MRI findings from first and re-presentation visits were recorded and statistically analysed.</p> Results <p>922 patients were included, 56 (6%) had True-CES on MRI and 356 met exclusion criteria, leaving 510 patients with normal MRI on initial presentation. 43 patients (8%) re-presented within one year (mean interval 152 days), and 7 presented a third time (mean interval 126 days). There was no significant difference in clinical symptoms, gender and bladder scans between presentations. No patient showed True-CES on re-presentation MRI, all demonstrating the same MRI findings as the initial scan.</p> Conclusion <p>This is the largest series of patients that evaluates re-presentations of suspected-CES after initial attendance with normal/No-CES MRI. There were no significant clinical/radiological differences between presentations. No patient showed True-CES on re-presentation MRI, and therefore, no predictive factors were identified.</p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

An evaluation of individuals who repeatedly present with suspected cauda equina syndrome

  • 期刊论文

  • 发表日期：

    2025年12月24日

查看全文
  • Alan Maximiliano Gessara,
  • Muhammad Ikram Patel,
  • Siddharth Shah,
  • Ali Shetaiwi,
  • Arvind Vatkar,
  • Michael Grevitt,
  • Mohammed Shakil Patel

摘要

Introduction

Cauda Equina Syndrome (CES) is a surgical emergency and an intimidating medico-legal challenge. Poor clinical specificity leads to a high rate of negative (normal/No-CES) MRI scans, placing additional burden on emergency services. A proportion of patients re-present with CES-like symptoms. The aim of this study was to assess this cohort of patients and identify the incidence, clinical risk factors, comparative MRI-findings and predictive factors for subsequent True-CES.

Methods

Retrospective review of prospective data of patients aged 18–65 years, who first attended with suspected-CES with a normal MRI, between January 2019-December 2022; and re-presented with suspected-CES within one year. Patients with True-CES or abnormal MRI pathology at first attendance were excluded. Clinical, bladder scan and MRI findings from first and re-presentation visits were recorded and statistically analysed.

Results

922 patients were included, 56 (6%) had True-CES on MRI and 356 met exclusion criteria, leaving 510 patients with normal MRI on initial presentation. 43 patients (8%) re-presented within one year (mean interval 152 days), and 7 presented a third time (mean interval 126 days). There was no significant difference in clinical symptoms, gender and bladder scans between presentations. No patient showed True-CES on re-presentation MRI, all demonstrating the same MRI findings as the initial scan.

Conclusion

This is the largest series of patients that evaluates re-presentations of suspected-CES after initial attendance with normal/No-CES MRI. There were no significant clinical/radiological differences between presentations. No patient showed True-CES on re-presentation MRI, and therefore, no predictive factors were identified.