![]() The British Association of Spine Surgeons (BASS) emphasized that an urgent MRI scan should be performed for suspected CES, and decompressive surgery should be undertaken at the earliest opportunity in confirmed cases. ![]() Magnetic resonance imaging (MRI) scan is essential to rule out cauda equina as no single or collective features will definitely confirm or exclude diagnosis. There is a debate in the literature questioning the accuracy of clinical features in the diagnosis of CES including saddle area anesthesia, perineal loss of sensation, sphincter dysfunction, bilateral sciatica, and motor and sensory function disturbances. In the United States, nearly half of the claims have been paid, and settlement costs millions of dollars per person. Missed CES represents the most common diagnoses associated with successful litigation and paying off huge sum of compensation to the victim thereby causing substantial financial strain in every health system in the world. Missing timely diagnosis of cauda equina compression can end up in irreversible bowel, bladder and sexual dysfunction. It is rare with an estimated incidence of 1 in 2000. There is a significant correlation between the PVR volume more than 200 ml and higher sensitivity and specificity.Ĭauda equina syndrome (CES) is an emergency spinal pathology that can lead to devastating permanent functional disabilities. ![]() Measuring the post-void urine volume using a bladder scan is an essential tool in the diagnosis of CES. The best results for both sensitivity and specificity in correlation with the sample of the study were for PVR more than 200 ml. Bladder scan diagnosed 70 cases and excluded 327. All articles included post-void bladder scans with the mentioned clear cut-off volume as a diagnostic parameter. A total of five study articles from 1955 fit with our inclusion and exclusion criteria. The total number of patients who had a bladder scan was 531. This was a comprehensive search using Medline, PubMed and Embase. The aim of the study is to perform a systematic review of the current evidence behind the use of the PVR bladder scan as a diagnostic tool for CES diagnosis. Furthermore, there is no clear cut-off point to consider PVR statistically significant. The post-void residual (PVR) volume bladder scan is useful in CES diagnosis, but to date there has been no single systematic review supporting its use. Bladder dysfunction can reflect CE compromise. Multiple studies have questioned the reliability of clinical assessment in diagnosing CES, whether some of the features should be considered to be potential red flags. Cauda equina syndrome (CES) is one of the emergency conditions that can lead to devastating permanent functional disabilities, if misdiagnosed.
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