Cauda Equina Syndrome; Roadside to Resus

The Resus Room

Simon Laing

Science, Emergencymedicine, Medicine, Health & Fitness, Em, Ae

4.8 • 678 Ratings

🗓️ 15 April 2024

⏱️ 40 minutes

🔗️ Recording | iTunes | RSS

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Summary

Lower back pain is a really common cause for patients to present to primary care, urgent care and emergency care.

Thankfully many of these cases are self limiting, but somewhere in the region of 1:300 patients with back pain in the ED will have Cauda Equina Syndrome.

Cauda Equina Syndrome is something that is challenging for all clinicians because many patients with simple lower back pain may have many similar symptoms, but if we miss it, or if there is a delay to surgery that can lead to potentially avoidable long-term disability for our patients and on top of that its a major cause of healthcare litigation.

And we’re not talking about a delay in weeks being a problem here, we’re talking about hours to days, with big potential complications like impaired bowel/bladder/sexual dysfunction or lower limb paralysis - so you can see why litigation is a big part of some missed cases.

In this episode we run through the the signs, symptoms, investigations and treatment with a strong reference back to the underlying anatomy and disruption.

We also cover the recently published national Cauda Equina Pathway, which is a great resource but poses some real challenges in it’s implementation!

Once again we’d love to hear any thoughts or feedback either on the website or via X @TheResusRoom!

Simon, Rob & James

Transcript

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0:00.0	Welcome to the Recess Room podcast.
0:03.5	Five, four, three, two, one, fire.
0:12.1	So hi, and welcome back to the Reeser Room podcast.
0:15.4	I'm Simon Lang.
0:16.9	I'm Rob Fenwick, and I'm James Yates.
0:19.1	And we're back with another roadside to recess
0:21.8	And this time, oh watch those backs
0:24.3	It's Corder Aquinasandrome
0:26.1	No chance are you pulling your back you're likely
0:30.5	Oh yeah it is corda equine syndrome
0:32.4	And this is one of those conditions
0:33.7	That really needs to be served up with a healthy side salad of respect because we
0:38.5	don't want to be missing this presentation so really looking forward to delving into the detail behind
0:42.9	it all yeah there are a load of nuggets in this certainly loads that we've learned running
0:47.5	through the prep for it so we hope this is a really useful episode for all of you out there
0:51.7	dealing with patients in emergency care.
0:59.9	Before we get into it, a huge thanks to Zol Medical Corporation, who collaborate with us on the podcast and make this all free and open access and available to you.
1:04.8	So, no matter who is forcing you to listen to this, you don't have to pay for it.
1:10.1	So, without further ado, let's crack on with the
1:12.7	torture and let's talk about Corder Aquinas syndrome. Okay then, well, lower back pain is a really
1:22.2	common cause for patients to present to both primary care, urgent care and, of course, emergency care.
1:28.6	Now, thankfully, many of these cases are going to be absolutely fine and they are going to be
	...

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