Cauda equina syndrome Nervous System Diseases Cauda equina syndrome
Conditions
Interventions
Patients with cauda equina syndrome will be identified on admission to spinal units across the UK and asked to participate. Data relating to presentation, hospital admission, investigations, and follo
Sponsors
NHS Lothian
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Over 18 years old 2. Admitted to a specialist spinal service in the UK between 1st June 2018 and 31st May 2019 3. Capacity to provide informed consent for participation in this study 4. Diagnosis of clinical CES and structural compression of the cauda equina on imaging as determined by the treating clinician. Clinical CES includes any disturbance of saddle sensation, bladder function, bowel function, sexual dysfunction and bilateral sciatica associated with radiological compression of the cauda equina. The cauda equina compression can be due to any cause, including, but not limited to, disc, tumour, infection, etc
Exclusion criteria
Exclusion criteria: 1. Patients under 18 years old 2. Patients undergoing emergent decompression for unilateral motor or sensory symptoms (eg foot drop), without clinical evidence of CES 3. Patients referred with suspected CES where the diagnosis is not confirmed, for example patients with the clinical symptoms and signs of CES without radiological evidence of cauda equina compression 4. Patients not admitted to participating spinal centres in the UK 5. Patients admitted to a participating spinal centre before 1st June 2018 or after 31st May 2019 6. Patients who are unable to provide informed consent for participation in this study
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The incidence of CES as measured by the number of cases of CES in the UK in all collaborating centres | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. The presenting symptoms and signs in patients with CES: 1.1. Back pain and leg pain measured using visual analogue scores on admission 1.2. Low back pain disability measured using Oswestry Disability Index on admission 1.3. Urinary bladder function measured using neurogenic bowel dysfunction score on admission 1.4. Urinary incontinence measured using short form incontinence questionnaire on admission 1.5. Sexual function measured using Arizona sexual experiences scale on admission 2. The pathways of presentation to specialist spinal services for patients with CES in the UK and Ireland; the type and timing of healthcare professionals seen prior to admission with the symptoms causing admission will be assessed by patient questionnaire on admission 3. The type and timing of imaging and other investigation of patients with CES, collected on admission 4. The medical and surgical management of CES, including medications, type and timing of the operation, collected from routine neurosurgical notes 5. The type and timing of investigations and surgery will be compared to the British Association of Spine Surgeons (BASS) standards of care for suspected and confirmed compressive CES issued in 2015 and the Society of British Neurological Surgeons Care Quality Statement issued in October 2015 6. Clinical outcomes for patients with CES assessed using validated patient reported outcome measures, stratified by presentation, investigations, and management: 6.1. Back pain and leg pain measured using visual analogue scores at discharge, 6 months and 1 year 6.2. Low back pain disability measured using Oswestry Disability Index 6 months and 1 year 6.3. Urinary bladder function measured using neurogenic bowel dysfunction score at discharge, 6 months and 1 year 6. | — |
Countries
England, Northern Ireland, Scotland, United Kingdom
Contacts
Public ContactJulie;Ingrid Woodfield;Hoeritzauer
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Outcome results
None listed