The clinical features and outcome of scan-negative and scan-positive cases in suspected cauda equina syndrome: a retrospective study of 276 patients

• DOI: 10.1007/s00415-018-9078-2
• Publication Date: 2018-10-08T07:25:50Z
• Authors: Ingrid Hoeritzauer; Savva Pronin; Alan Carson; Patrick Statham; Andreas K. Demetr...; Jon Stone
• Keywords: Cauda Equina Syndrome; Cauda equina; Neuroradiology; Lumbosacral joint; Functional disorder

The majority of patients presenting with suspected clinical cauda equina syndrome (CES) have no identifiable structural cause for their symptoms ('scan-negative' CES). Understanding these aids differentiation and management in CES.A retrospective electronic note review was undertaken CES, defined as ≥ 1 acute bladder, bowel, sexual dysfunction or saddle numbness, to a regional neurosciences centre. We investigated radiology, features, psychiatric functional disorder comorbidities outcome 'scan-negative' CES MRI confirmed compression the ('scan-positive' CES).276 were seen over 16 months. There three main radiologically patient groups: (1) 'scan-positive' (n = 78, mean age 48 years, 56% female), (2) without central canal stenosis but lumbosacral nerve root not explaining presentation 87, 43 68% female) (3) neural compromise 104, 42 70% female). In two groups (no compression), there higher rates disorders (37% 29% vs. 9%), neurological (12% 11% vs 0%) comorbidity (53% 40% 20%). On follow-up (mean 13-16 months), only 191 diagnosed an explanatory (transverse myelitis).The data support model which scan-negative arises end pathway pain, sometimes partly findings vulnerability disorders.