Timely detection and treatment of cauda equina syndrome

The British Association of Spine Surgeons (BASS) welcomes this report and the safety recommendations to improve the care of patients suffering from cauda equina syndrome (CES). We recognise a number of different guidelines and pathways are already available, as well as safety netting advice from nationally recognised bodies (including National Institute of Health and Clinical Excellence, and the Chartered Society of Physiotherapy).

We will oversee a review of available documentation and propose consolidated guidance for the recommendations proposed. We will also carry out a survey of surgeons involved in the care of CES patients to inform the process as well as carry out an evidence review of the subject.

The aim of the work we will do is to provide a collaborative document (with the Royal College of Surgeons of England, Royal College of Radiologists and the Royal College of Emergency Medicine) to establish agreed standardised terms, a decision making tool, time frames for scanning and referral and improving the surgical aspect of the pathway.

We recognise that the majority of patients presenting as suspected CES in the United Kingdom (UK) are not shown to be surgical emergencies and any guidance needs to ensure that the screening process for a suspected CES is as rapid as possible to facilitate access to emergency surgery when required. This may well need a change in current working practice across the UK.

Action: Review of current published guidelines with RCR, RCS, RCEM, RCGP, interface clinicians. Review of evidence and a surgeon survey with patient groups, interface clinicians and GPs.

Response received on 15 November 2021.