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Immediate MRI of the lumbar spine
97%
1080/1111
General reassurance, anti-inflammatory drugs, and an early home exercise program
0%
4/1111
Immediate radiographs of the lumbar spine and pain medications with 2 days of bed rest if the radiographs are normal
1%
8/1111
Office caudal epidural steroid injection with follow-up in 1 week
6/1111
Outpatient MRI of the lumbar spine with follow-up in 1 week for test results
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Cauda equina syndrome is a medical emergency that must be quickly diagnosed and treated to avoid long-term complications. Cauda equina syndrome typically presents with low back pain, unilateral or usually bilateral sciatica, saddle sensory disturbances, bladder and bowel dysfunction, and variable lower extremity motor and sensory loss. Although a number of pathologies can cause cauda equina syndrome, in a patient with a history of chronic back pain, disk pathology is the most common cause of acute onset cauda equina syndrome. Whereas radiographs may be useful in a traumatic onset of symptoms, MRI is the most appropriate study. Cauda equina syndrome should be evaluated on an emergent basis and admission for work-up is appropriate.
4.8
(6)
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