Treatment of Cauda Equina Syndrome with Thecal Sac Compression and Positive MRI Findings

This protocol addresses the management of cauda equina syndrome presenting with thecal sac compression alongside both subjective symptoms and objective neurological signs, confirmed by positive MRI findings — a presentation classified as incomplete CES (CESI).

Clinical Scenario

The patient presents with thecal sac compression associated with subjective symptoms and objective signs of cauda equina syndrome. MRI findings are positive. This combination — symptomatic presentation with measurable neurological deficits and radiological confirmation — defines cauda equina syndrome incomplete (CESI) and carries specific management implications.

Treatment Approach

When thecal sac compression is confirmed alongside clinical CES signs and positive MRI, a surgical intervention is indicated. The full protocol specifies the timing priority and procedural guidance.

Complete regimen, sequencing, and decision criteria available in the full protocol →

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References

DOI: 10.32587/jnic.2019.00136

Thecal sac compression with subjective symptoms and objective signs of CES is CESI (incomplete CES).

If the MRI findings are positive and clinical symptoms indicate CESI, surgical procedure should be performed as soon as possible.

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