A man with back pain develops urinary retention, saddle numbness and bilateral leg weakness. What is the right management?
Answer and explanation
Correct answer: A. Emergency spinal MRI and urgent neurosurgical referral
- Step 1: These are red flag features of cauda equina syndrome. Step 2. It needs urgent imaging and surgical decompression to prevent permanent bladder, bowel and sexual dysfunction. Answer: Emergency spinal MRI and urgent neurosurgical referral. Why not the others: Delay risks irreversible damage. Physiotherapy is inappropriate for a compressive emergency. Lumbar puncture does not assess spinal compression.
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