Published 31 March 2009, doi:10.1136/bmj.b936
Cite this as: BMJ 2009;338:b936

Clinical Review

Cauda equina syndrome

Chris Lavy, honorary professor and consultant orthopaedic surgeon, Andrew James, specialist registrar, James Wilson-MacDonald, consultant spine surgeon, Jeremy Fairbank, professor of spine surgery

1 Nuffield Department of Orthopaedic Surgery, Nuffield Orthopaedic Centre, Oxford OX3 7LD

Correspondence to: C Lavy christopher.lavy@ndos.ox.ac.uk

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


Cauda equina syndrome is rare, but devastating if symptoms persist
Clinical diagnosis is not easy and even in experienced hands is associated with a 43% false positive rate
The investigation of choice is magnetic resonance imaging
Once urinary retention has occurred the prognosis is worse
Good retrospective evidence supports urgent surgery especially in early cases
Litigation is common when the patient has residual symptoms


An understanding of cauda equina syndrome is important not only to orthopaedic surgeons and neurosurgeons but also to general practitioners, emergency department staff, and other specialists to whom these patients present. Recognition of the syndrome by all groups of clinicians is often delayed as it presents with bladder, bowel, and sexual problems, which are common complaints and have a variety of causes. Patients may not mention such symptoms because of embarrassment or because the onset is slow and insidious.

Cauda equina syndrome is a clinical area . . . [Full text of this article]


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