Safety recommendation
HSIB recommends that the National Institute for Health and Care Excellence updates its current low back pain guideline to include the symptoms and initial management of cauda equina syndrome. This update should include a review of the role of supplementary investigations, such as bladder scanning, in patients with suspected cauda equina syndrome
Response:
Following consideration of the Healthcare Safety Investigation Branch’s report, the National Institute for Health and Care Excellence (NICE) will update its guideline on low back pain and sciatica in over 16s [NG59] to include cauda equina syndrome.
Cauda equina syndrome was outside the scope of the original guideline and so it does not make recommendations on the assessment or management of people with this condition.
In its guideline on suspected neurological conditions: recognition and referral [NG127], NICE recommends that clinicians refer immediately adults who have severe low back pain radiating into the leg and new-onset disturbance of bladder, bowel or sexual function, or new-onset perineal numbness, to have an assessment for cauda equina syndrome (see recommendation 1.7.3).
Action: Commission update of NG59 and update NG59 to include cauda equina syndrome.
Response received on 12 November 2021.