When degenerative lumbar spine disease presents alongside acute neurologic deterioration within 48 hours, the clinical picture changes fundamentally — and so does the management pathway.
Acute neurologic deficit of less than 48 hours duration in a patient with degenerative lumbar spine disease — specifically: lower-extremity muscle weakness of MRC grade 3/5 or worse, or findings consistent with conus medullaris syndrome, or cauda equina syndrome.
This presentation calls for an emergency surgical pathway. The approach involves urgent decompressive intervention at the lumbar spine — the details of the evaluation sequence and operative decision-making are specified in the full protocol.
DOI: 10.3238/arztebl.m2025.0056