Suspected Cauda Equina Syndrome
Cauda equina syndrome (CES) is a notoriously difficult diagnosis to make clinically. As of April 2025 there is a BNSSG working group, designing a new local pathway for CES. The current approach to CES in BNSSG is described on the REMEDY page here: Cauda Equina Syndrome (Remedy BNSSG ICB). As guidance is updated it will be published on the REMEDY page.
BNSSG guidelines refer to recently published NHS England 'Getting It Right First Time' (GIRFT) guidance on the presentation and management of CES in primary and community care: Spinal – CES Presentation in Primary & Community Care 3a-1 – GIRFT – Pathways. Patients with suspected CES should be sent to their local ED for urgent imaging.
Confirmed Cauda Equina Syndrome
If cauda equina is identified on an outpatient scan, the community referrer can contact neurosurgery via refer a patient.
NB please also note that if a HCP has a confirmed diagnosis of Cauda Equina (eg. on an outpatient MRI) then do not send to BRI ED they would need to go to Southmead.
Key words: neurosurgery, neurosurgeons, neuro