Specialist rehabilitation

doi:10.1136/bmj.b1725

Published 29 April 2009, doi:10.1136/bmj.b1725
Cite this as: BMJ 2009;338:b1725

Letters

Cauda equina syndrome

Specialist rehabilitation

The first 150 words of the full text of this article appear below.

Lavy and colleagues note that recovery from cauda equina syndromemay often be incomplete.¹ Patients may continue to experienceproblems with sexuality and continence dysfunction, neuropathicpain, mobility limitations, and adjustment.

Patients with cauda equina syndrome who have any persistingsymptoms postoperatively should be referred to a rehabilitationconsultation to assist with planning the best ongoing care.²In the early period, care is crucial to prevent suboptimal managementof bladder dysfunction. This can sometimes be difficult to fullyappreciate as patients may partially void but still have a largeresidual urine volume, which can compromise bladder recoveryand predispose to urinary tract infections.³ Steps must alsobe taken to prevent pressure ulcers, which may have devastatingconsequences.⁴

Longstanding best practice in most developed countries is torefer patients with spinal cord injury to a specialist rehabilitationunit.⁵ There, patients have the best chance of optimal managementof persisting deficits and . . . [Full text of this article]

Peter W New, head¹

¹ Spinal Rehabilitation Unit, Caulfield Hospital, Caulfield, VIC 3162, Australia

p.new@cgmc.org.au