Article
Can physiotherapists recognise Cauda equina syndrome (CES) better than doctors?
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Published: | October 21, 2010 |
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Objective: Recent articles in the medical press highlight the potential dangers of Cauda Equina Syndrome (CES). CES has the highest rates of litigation due to its long-term neurological impairment, which can lead to devastating outcome on patients. The aim of this study was to assess health care professionals knowledge with regards to the urinary symptoms of CES and the timeframe in which treatment should be offered.
Methods: A 4-part questionnaire was constructed establishing the type of medical professional and number of musculoskeletal cases seen per week. The participant was asked to rank 15 urinary symptoms from most to least alarming. 7 of the symptoms were not related to CES. The participants were asked the ideal time to surgical intervention for Complete CES and Incomplete CES.
Results and conclusions: A total of 44 questionnaires were analysed. Both doctors and physiotherapists ranked the CES symptoms on average significantly higher than then the non-CES symptoms. The physiotherapists rated the CES symptoms significantly higher than the doctors (P=0.05) and on average rated the non-CES symptoms significantly lower than doctors (P<0.05).
87.8% thought that complete CES should be treated <24 hours and 9.76% thought that complete CES should be treated from 24–48 hours. 46.34% thought that CESI should be treated <24 hours and 43.9% thought that CESI should be treated from 24–48 hours.
These results demonstrate that physiotherapists are better than Doctors at identifying the urinary symptoms in CES. The majority of health care professional who took part in this study stated that they would offer surgical intervention for both Complete and Incomplete CES within 24 hours. The gap in knowledge highlights the need for education to all medical professionals in the symptoms of CES and also the timing of treatment.