Cauda Equina Syndrome Tips for the General Orthopaedic On Call Surgeon

Description

In this presentation by Hui-Ling Kerr, the critical nature of timely intervention for Cauda Equina Syndrome (CES) is emphasized, as delays can result in devastating long-term disabilities for young patients. Using vivid imagery, Kerr analogizes CES to a jungle, illustrating the challenges in diagnosis and the potential for missed opportunities. She shares poignant examples of individuals who suffered severe consequences due to late surgical intervention, such as irreversible bladder and bowel dysfunction, loss of sexual function, and subsequent mental health issues, including depression and suicides related to their conditions. Kerr highlights historic findings demonstrating that surgical outcomes improve significantly if intervention occurs within 48 hours, stressing the importance of early recognition and action. Furthermore, she addresses common misunderstandings and assessment fatigue among medical professionals, advocating for a clearer approach to diagnosing CES which includes a focus on specific urine retention measurements as indicators. The presentation also introduces the GIRFT (Getting It Right First Time) pathway designed to improve management and referral processes, ensuring emergency assessments lead to expedited MRI scans and necessary surgical interventions. Ultimately, Kerr calls for changes to be actively implemented in clinical settings, emphasizing that consistent monitoring, interdisciplinary collaboration, and patient education are vital in managing the aftermath of CES.

DOI: 10.1302/3114-240883

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