| Cauda equina syndrome: a review of the current clinical and medico-legal position. | |
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MedLine Citation:
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PMID: 21193933 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Cauda equina syndrome (CES) is a rare condition with a disproportionately high medico-legal profile. It occurs most frequently following a large central lumbar disc herniation, prolapse or sequestration. Review of the literature indicates that around 50-70% of patients have urinary retention (CES-R) on presentation with 30-50% having an incomplete syndrome (CES-I). The latter group, especially if the history is less than a few days, usually requires emergency MRI to confirm the diagnosis followed by prompt decompression by a suitably experienced surgeon. Every effort should be made to avoid CES-I with its more favourable prognosis becoming CES-R while under medical supervision either before or after admission to hospital. The degree of urgency of early surgery in CES-R is still not in clear focus but it cannot be doubted that earliest decompression removes the mechanical and perhaps chemical factors which are the causes of progressive neurological damage. A full explanation and consent procedure prior to surgery is essential in order to reduce the likelihood of misunderstanding and litigation in the event of a persistent neurological deficit. |
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Authors:
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Alan Gardner; Edward Gardner; Tim Morley |
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Publication Detail:
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Type: Journal Article; Review Date: 2010-12-31 |
Journal Detail:
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Title: European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society Volume: 20 ISSN: 1432-0932 ISO Abbreviation: Eur Spine J Publication Date: 2011 May |
Date Detail:
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Created Date: 2011-04-27 Completed Date: 2012-03-26 Revised Date: 2012-05-01 |
Medline Journal Info:
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Nlm Unique ID: 9301980 Medline TA: Eur Spine J Country: Germany |
Other Details:
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Languages: eng Pagination: 690-7 Citation Subset: IM |
Affiliation:
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South Essex University Hospitals and The Essex Spine Centre, Brentwood, UK. adhg@btopenworld.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Decompression, Surgical
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legislation & jurisprudence,
methods,
standards* Early Diagnosis Emergency Medical Services / legislation & jurisprudence, methods, standards* Great Britain Humans Intervertebral Disc Displacement / complications, diagnosis, surgery* Malpractice / legislation & jurisprudence, trends* Neurologic Examination / methods, standards Polyradiculopathy / diagnosis, etiology, surgery* Postoperative Complications / etiology, prevention & control |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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