21d • General discussion
Just Sent a Patient to Spine Surgeon
Pt. Presented with history of chronic low back pain. Recent trauma/fall, couldn’t stand up. History sounded like back spasm with acute SI joint/sacral torsion and shear at first.
Until I asked, “Have you had any bowel and bladder dysfunction?” He said yes 1.5 weeks ago after the trauma he twisted and defecated on himself hasn’t happened since. He was shocked. No weakness in his legs.
I said I need you to see a spine MD ASAP. I said if it happens again or weakness in legs go to ER ASAP.
Every LBP eval I ask/screen
- Bowel/bladder dysfunction
- Myotome weakness
- Saddle Anesthesia
- Hx of recent trauma
I have now caught Cauda Equina Syndrome 6x in my career (assuming this was the 6th). Once the patient had seen the appropriate specialist and the questions were not asked.
Have you caught CES before? Comment below…
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Just Sent a Patient to Spine Surgeon
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