Last reviewed: 5 Nov 2023
Last updated: 06 Feb 2023
Summary
Definition
History and exam
Key diagnostic factors
- bladder dysfunction
- lower limb weakness
- saddle paresthesia/anesthesia
- bowel dysfunction
More key diagnostic factors
Other diagnostic factors
- low back pain
- sciatica
- sexual dysfunction
Other diagnostic factors
Risk factors
- lumbar disk herniation
- spinal trauma
- spinal surgery
- spinal epidural abscess
- anticoagulation therapy
- spinal stenosis
- spinal tumor
- ages under 50 years
More risk factors
Diagnostic investigations
1st investigations to order
- MRI lumbar spine without IV contrast
- CT lumbar spine without IV contrast
More 1st investigations to order
Investigations to consider
- CT myelography of the lumbar spine
- urodynamic testing
- digital rectal exam
More investigations to consider
Treatment algorithm
ACUTE
confirmed CES
Contributors
Authors
Kenneth F. Casey, MD, FACS
Clinical Associate Professor
Neurosurgery
Michigan State University
Clinical Associate Professor
Physical Medicine and Rehabilitation
Wayne State University School of Medicine
Detroit
MI
Disclosures
KFC declares that he has no competing interests.
Peer reviewers
Kevin Barraclough, MA, FRCP, FRCGP, LLB
GP
Painswick Surgery
Painswick
Gloucester
UK
Disclosures
KB is an author of references cited in this topic. KB declares that he has no competing interests.
Louis Chang, MD
Assistant Professor of Neurological Surgery
Weill Cornell Medicine
New York
NY
Disclosures
LC declares that he has no competing interests.
Differentials
- Spinal epidural abscess
- Osteoporotic spinal compression fracture
- Transverse myelitis
More DifferentialsGuidelines
- Best practice guidelines: spine injury
- ACR appropriateness criteria: low back pain
More GuidelinesPatient leaflets
Spinal cord compression: what treatments work?
Spinal cord compression: what is it?
More Patient leafletsLog in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer