ABSTRACT
This chapter presents a case study of a 45-year-old man with acute onset lower back pain after a gym session. This is a case of cauda equina syndrome (CES). The signs and symptoms of lower extremity weakness and pain developing acutely after heavy lifting should raise suspicion for a herniated intervertebral disc, which is the commonest cause of CES. While CES is primarily a clinical diagnosis, further imaging will be required to aid decision-making and operative planning. A multitude of alternative diagnoses may masquerade as CES – stroke, vascular claudication, deep venous thrombosis, muscle cramps and peripheral neuropathy. A good history and examination will help differentiate these from true CES. If there is a concern for bony fracture from trauma, a non-contrast CT should be performed. While awaiting an MRI, a full blood count, electrolytes, coagulation studies and a group and save should be obtained in anticipation of surgical intervention.
