Understanding cauda equina syndrome: protocol for a UK multicentre prospective observational cohort study

Julie Woodfield; Ingrid Hoeritzauer; Aimun A.B. Jamjoom; Savva Pronin; Nisaharan Srikandarajah; Michael Poon; Holly Roy; Andreas K. Demetriades; Philip Sell; Niall Eames; Patrick F.X. Statham

doi:10.1136/bmjopen-2018-025230

Understanding cauda equina syndrome: protocol for a UK multicentre prospective observational cohort study

Julie Woodfield^*, Ingrid Hoeritzauer, Aimun A.B. Jamjoom, Savva Pronin, Nisaharan Srikandarajah, Michael Poon, Holly Roy, Andreas K. Demetriades, Philip Sell, Niall Eames, Patrick F.X. Statham

^*Corresponding author for this work

Peninsula Medical School

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Abstract

IntroductionCauda equina syndrome (CES) is a potentially devastating condition caused by compression of the cauda equina nerve roots. This can result in bowel, bladder and sexual dysfunction plus lower limb weakness, numbness and pain. CES occurs infrequently, but has serious potential morbidity and medicolegal consequences. This study aims to identify and describe the presentation and management of patients with CES in the UK.Methods and analysisUnderstanding Cauda Equina Syndrome (UCES) is a prospective and collaborative multicentre cohort study of adult patients with confirmed CES managed at specialist spinal centres in the UK. Participants will be identified using neurosurgical and orthopaedic trainee networks to screen referrals to spinal centres. Details of presentation, investigations, management and service usage will be recorded. Both patient-reported and clinician-reported outcome measures will be assessed for 1 year after surgery. This will establish the incidence of CES, current investigation and management practices, and adherence to national standards of care. Outcomes will be stratified by clinical presentation and patient management. Accurate and up to date information about the presentation, management and outcome of patients with CES will inform standards of service design and delivery for this important but infrequent condition.Ethics and disseminationUCES received a favourable ethical opinion from the South East Scotland Research Ethics Committee 02 (Reference: 18/SS/0047; IRAS ID: 233515). All spinal centres managing patients with CES in the UK will be encouraged to participate in UCES. Study results will be published in medical journals and shared with local participating sites.Trial registration numberISRCTN16828522; Pre-results.

Original language	English
Pages (from-to)	e025230-e025230
Number of pages	0
Journal	BMJ Open
Volume	8
Issue number	12
Early online date	14 Dec 2018
DOIs	https://doi.org/10.1136/bmjopen-2018-025230
Publication status	Published - 14 Dec 2018

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title = "Understanding cauda equina syndrome: protocol for a UK multicentre prospective observational cohort study",

abstract = "IntroductionCauda equina syndrome (CES) is a potentially devastating condition caused by compression of the cauda equina nerve roots. This can result in bowel, bladder and sexual dysfunction plus lower limb weakness, numbness and pain. CES occurs infrequently, but has serious potential morbidity and medicolegal consequences. This study aims to identify and describe the presentation and management of patients with CES in the UK.Methods and analysisUnderstanding Cauda Equina Syndrome (UCES) is a prospective and collaborative multicentre cohort study of adult patients with confirmed CES managed at specialist spinal centres in the UK. Participants will be identified using neurosurgical and orthopaedic trainee networks to screen referrals to spinal centres. Details of presentation, investigations, management and service usage will be recorded. Both patient-reported and clinician-reported outcome measures will be assessed for 1 year after surgery. This will establish the incidence of CES, current investigation and management practices, and adherence to national standards of care. Outcomes will be stratified by clinical presentation and patient management. Accurate and up to date information about the presentation, management and outcome of patients with CES will inform standards of service design and delivery for this important but infrequent condition.Ethics and disseminationUCES received a favourable ethical opinion from the South East Scotland Research Ethics Committee 02 (Reference: 18/SS/0047; IRAS ID: 233515). All spinal centres managing patients with CES in the UK will be encouraged to participate in UCES. Study results will be published in medical journals and shared with local participating sites.Trial registration numberISRCTN16828522; Pre-results.",

author = "Julie Woodfield and Ingrid Hoeritzauer and Jamjoom, {Aimun A.B.} and Savva Pronin and Nisaharan Srikandarajah and Michael Poon and Holly Roy and Demetriades, {Andreas K.} and Philip Sell and Niall Eames and Statham, {Patrick F.X.}",

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T1 - Understanding cauda equina syndrome: protocol for a UK multicentre prospective observational cohort study

AU - Woodfield, Julie

AU - Hoeritzauer, Ingrid

AU - Jamjoom, Aimun A.B.

AU - Pronin, Savva

AU - Srikandarajah, Nisaharan

AU - Poon, Michael

AU - Roy, Holly

AU - Demetriades, Andreas K.

AU - Sell, Philip

AU - Eames, Niall

AU - Statham, Patrick F.X.

PY - 2018/12/14

Y1 - 2018/12/14

N2 - IntroductionCauda equina syndrome (CES) is a potentially devastating condition caused by compression of the cauda equina nerve roots. This can result in bowel, bladder and sexual dysfunction plus lower limb weakness, numbness and pain. CES occurs infrequently, but has serious potential morbidity and medicolegal consequences. This study aims to identify and describe the presentation and management of patients with CES in the UK.Methods and analysisUnderstanding Cauda Equina Syndrome (UCES) is a prospective and collaborative multicentre cohort study of adult patients with confirmed CES managed at specialist spinal centres in the UK. Participants will be identified using neurosurgical and orthopaedic trainee networks to screen referrals to spinal centres. Details of presentation, investigations, management and service usage will be recorded. Both patient-reported and clinician-reported outcome measures will be assessed for 1 year after surgery. This will establish the incidence of CES, current investigation and management practices, and adherence to national standards of care. Outcomes will be stratified by clinical presentation and patient management. Accurate and up to date information about the presentation, management and outcome of patients with CES will inform standards of service design and delivery for this important but infrequent condition.Ethics and disseminationUCES received a favourable ethical opinion from the South East Scotland Research Ethics Committee 02 (Reference: 18/SS/0047; IRAS ID: 233515). All spinal centres managing patients with CES in the UK will be encouraged to participate in UCES. Study results will be published in medical journals and shared with local participating sites.Trial registration numberISRCTN16828522; Pre-results.

AB - IntroductionCauda equina syndrome (CES) is a potentially devastating condition caused by compression of the cauda equina nerve roots. This can result in bowel, bladder and sexual dysfunction plus lower limb weakness, numbness and pain. CES occurs infrequently, but has serious potential morbidity and medicolegal consequences. This study aims to identify and describe the presentation and management of patients with CES in the UK.Methods and analysisUnderstanding Cauda Equina Syndrome (UCES) is a prospective and collaborative multicentre cohort study of adult patients with confirmed CES managed at specialist spinal centres in the UK. Participants will be identified using neurosurgical and orthopaedic trainee networks to screen referrals to spinal centres. Details of presentation, investigations, management and service usage will be recorded. Both patient-reported and clinician-reported outcome measures will be assessed for 1 year after surgery. This will establish the incidence of CES, current investigation and management practices, and adherence to national standards of care. Outcomes will be stratified by clinical presentation and patient management. Accurate and up to date information about the presentation, management and outcome of patients with CES will inform standards of service design and delivery for this important but infrequent condition.Ethics and disseminationUCES received a favourable ethical opinion from the South East Scotland Research Ethics Committee 02 (Reference: 18/SS/0047; IRAS ID: 233515). All spinal centres managing patients with CES in the UK will be encouraged to participate in UCES. Study results will be published in medical journals and shared with local participating sites.Trial registration numberISRCTN16828522; Pre-results.

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DO - 10.1136/bmjopen-2018-025230

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SN - 2044-6055

VL - 8

SP - e025230-e025230

JO - BMJ Open

JF - BMJ Open

IS - 12

ER -

Understanding cauda equina syndrome: protocol for a UK multicentre prospective observational cohort study

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