This algorithm has been employed in the clinical practice of the lead investigator for the past 26 months, in which time no patient has come to any harm from its application. Patients with normal perianal sensation and residual urine volume (volume of urine left in the bladder) less than 100ml will be classified as low risk and receive MRI as an outpatient within one working week, whereas those with abnormal perianal sensation or residual urine volume greater than 100ml will be deemed high risk and undergo urgent MRI. Appendix 1 outlines the algorithm that will be followed. By determining the likelihood of acute CES, clinicians may be able to ration the use of out of hours emergency MRI more effectively.Īll patients presenting to the Royal Devon and Exeter NHS Foundation Trust with suspected acute CES who meet our pre-defined inclusion criteria will be included in this study. The aim of this study is to test a clinical algorithm which employs both clinical examination and ultrasound bladder scanning to stratify patients into high and low risk groups of having acute CES. ![]() Urgent use out of hours MRI scanning for these patients is expensive, wasteful and places strain on limited NHS resources. ![]() Magnetic resonance imaging (MRI) provides definitive evidence of CES, however the majority of patients who undergo this investigation do not demonstrate cauda equina compression and therefore do not require surgery. Patient presentation is variable and therefore diagnosing CES based on clinical features can be unreliable and subjective. Acute cauda equina syndrome is a relatively rare but potentially devastating spinal surgical emergency.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |