Nice analysis of diagnosing CES Brit and Alex. I was surprised at how poor each of the likelihood ratios are for this. Urinary retention appears to be nearly worthless. I see a fair number of patients with what I am calling “partial CES” and I frame it that way when speaking to the neurosurgeon because once it’s complete I assume it is permanent. This is usually in the pt who has back pain, bilateral paresthesias (or pain), has fallen but is not paralyzed and has had difficulty emptying their bladder. When combined this way maybe it has a higher +LR? In every case when I describe it as a “partial CES” to the surgeon they have performed decompressive laminectomy. Nice table of statistical characteristics. Thanks for the valuable information.
Steve Shroyer
3 Responses to “Learn to Spot and Treat Cauda Equina Syndrome”
March 1, 2020
Jerry W. Jones, MD FACEP FAAEMExcellent review! Thank you!
March 1, 2020
Steven ShroyerNice analysis of diagnosing CES Brit and Alex. I was surprised at how poor each of the likelihood ratios are for this. Urinary retention appears to be nearly worthless. I see a fair number of patients with what I am calling “partial CES” and I frame it that way when speaking to the neurosurgeon because once it’s complete I assume it is permanent. This is usually in the pt who has back pain, bilateral paresthesias (or pain), has fallen but is not paralyzed and has had difficulty emptying their bladder. When combined this way maybe it has a higher +LR? In every case when I describe it as a “partial CES” to the surgeon they have performed decompressive laminectomy. Nice table of statistical characteristics. Thanks for the valuable information.
Steve Shroyer
March 1, 2020
CA Kennedy MFExcellent summary. Thanks!