Faculty Advisor(s)
Molly Collin
Document Type
Course Paper
Publication Date
2021
Rights
© 2021 The Authors
Abstract
Background: Cauda equina syndrome (CES) is a collection of symptoms that can present as the result of many different spinal cord pathologies. CES is a medical emergency and often requires immediate surgical intervention to prevent permanent damage. The criteria for screening and diagnosis for CES is observed to be inconsistent and varied among healthcare professionals.
Case Description: A 53-year-old female was involved in a motor vehicle accident (MVA), resulting in her experiencing a concussion, and fracture of the left (L) ankle and right (R) femur. She required R hip surgery and was given a bilateral lower extremity non-weight bearing status. She had several computerized tomography scans and was determined to have no significant neurological injuries to the spine. She progressed through physical therapy (PT) in the hospital and was referred to the skilled nursing facility (SNF) for continued rehabilitation as she was unable to return home independently at that time. On initial examination at the SNF, the student physical therapist (SPT) determined that the patient presented with neurological symptoms that were not noted on the hospital discharge notes. The patient reported experiencing saddle paresthesia and could not determine if she was urinating or not. Findings were consistent with CES. The patient was sent back to the hospital for an MRI which showed compression of her spine in the thoracic region but was determined to be non-emergent and required no surgery at that time. The patient returned to the SNF for further therapy. The patient received education on how to safely move in bed to protect the spine, supine therapeutic exercises, and manual therapy. After imaging was obtained, and the patient cleared for weight bearing, treatment was then focused on ambulation with the continuation of the therapeutic exercises for strengthening.
Outcomes: During the re-evaluation, the patient completed the Six-Minute Walk Test and the 30-Second Sit to Stand test. The patient progressed each week through PT and became more mobile. At the time of discharge, she was ambulating with an Aircast on her L lower extremity and without the need for a two-wheeled walker.
Discussion: Red flag screening is a tool that must be used in order to effectively diagnose and treat patients with underlying critical health conditions. Severe health conditions make up a very small number of diagnoses seen during a PT evaluation, but should not be overlooked. It is the duty of all healthcare professionals to screen for vital pathologies and deficits to provide the pinnacle of care for our patients.
Recommended Citation
Guimond, Erica; Buckhalt, Hayden; Adler, Brendan; and Bourassa, Spencer, "Cauda Equina Syndrome In A 53-Year-Old Female Following A Motor Vehicle Accident: A Case Report" (2021). Case Report Papers. 133.
https://dune.une.edu/pt_studcrpaper/133
