Cauda equina syndrome: time to prioritise education and patient care

Cauda equina syndrome is a rare, severe spinal condition requiring urgent evaluation and co-ordinated care. This article addresses educational priorities and care practices for nurses managing cauda equina syndrome, based on a survey of patients with the syndrome. The aim was to review literature, Getting It Right First Time guidelines, Freedom of Information surveys, and a patient survey conducted by support group Cauda Equina Spinal Cord Injury regarding bladder and bowel dysfunction following cauda equina syndrome diagnosis and surgery. Delays in diagnosis, variations in care and unmet patient needs were researched. An anonymous online survey, including multiple choice and open-ended questions, was developed and hosted on the Enalyzer platform from 11 August to 3 September 2023. The online survey collected data on diagnosis, management and quality of life for those living with cauda equina syndrome. Participants were recruited via a members-only Facebook page. Data from 137 responses was collected and analysed. This article integrates Getting It Right First Time national reports, Freedom Of Information responses from NHS trusts and published literature, highlighting roles for nurses and specialist services. Responses indicated diagnostic inconsistencies, low adoption of the cauda equina pathway, and suggested that there had been significant impact on patients' bladder, bowel and sexual function, as well as mental wellbeing. Nurse-led specialist services, improved training in neurogenic management, guideline adherence, clear referral pathways and patient information are recommended.