Cauda equina syndrome: The development of a citywide physiotherapy pathway of care

Abstract

Cauda Equina Syndrome (CES) is a very rare condition in patients with low back pain (LBP), however, the discovery of CES is seen as a surgical emergency. With the rapid rolling out of patient self-referral to outpatient physiotherapy, there is an increased likelihood of physiotherapists being exposed to this condition. However, the literature to date has focused on CES from a medical perspective and clear physiotherapy guidelines have not been reviewed. To improve and standardize the citywide management of such patients a pathway of care was developed. Clinical specialist physiotherapists oversaw the development guided by orthopaedic and neurosurgery consultants. The results of a three-cycle audit suggest this evidence-based pathway of care is an effective tool in identifying patients with CES.