The ability to incorporate flexion and extension radiographs is essential to identify segmental motion, which is important in the surgical management of spondylolisthesis [24,37]. Lateral bending images have been shown to be helpful in spinal deformity correction surgery [25]. Variant 4: Low back pain with suspected cauda equina syndrome. Initial imaging. CES is rare and results from dysfunction of the sacral and lumbar nerve roots within the vertebral canal secondary to cauda equina nerve root compression, producing impairment of the bladder, bowel, or sexual function and perianal or saddle numbness. Back pain with or without radicular symptoms, weakness in the lower limbs, sensory changes or numbness in the lower limbs, or absent lower limb reflexes are other symptoms that have been described [38]. A review of physical examination findings reported by Fairbanks et al [39] found LBP as the most common physical finding in patients with the diagnosis of CES. The most common cause of CES is lumbar disc herniation at the L4-L5 and L5-S1 levels. Other etiologies include neoplasm, infection/inflammation, spinal stenosis, and hemorrhage. The imaging study of choice in the evaluation of suspected CES, multifocal deficit, or progressive neurologic deficit is MRI because of its ability to accurately depict soft-tissue pathology, assess vertebral marrow, and assess the Low Back Pain spinal canal patency. MRI lumbar spine without IV contrast is most useful in the evaluation of suspected CES, multifocal deficit, or progressive neurologic deficit because of its ability to accurately depict soft-tissue pathology, assess vertebral marrow, and assess the spinal canal patency. A prospective cohort study by Bell et al [41] recommends urgent MRI assessment in all patients who present with new-onset urinary symptoms in the context of LBP or sciatica.
Low Back Pain PCAs. The ability to incorporate flexion and extension radiographs is essential to identify segmental motion, which is important in the surgical management of spondylolisthesis [24,37]. Lateral bending images have been shown to be helpful in spinal deformity correction surgery [25]. Variant 4: Low back pain with suspected cauda equina syndrome. Initial imaging. CES is rare and results from dysfunction of the sacral and lumbar nerve roots within the vertebral canal secondary to cauda equina nerve root compression, producing impairment of the bladder, bowel, or sexual function and perianal or saddle numbness. Back pain with or without radicular symptoms, weakness in the lower limbs, sensory changes or numbness in the lower limbs, or absent lower limb reflexes are other symptoms that have been described [38]. A review of physical examination findings reported by Fairbanks et al [39] found LBP as the most common physical finding in patients with the diagnosis of CES. The most common cause of CES is lumbar disc herniation at the L4-L5 and L5-S1 levels. Other etiologies include neoplasm, infection/inflammation, spinal stenosis, and hemorrhage. The imaging study of choice in the evaluation of suspected CES, multifocal deficit, or progressive neurologic deficit is MRI because of its ability to accurately depict soft-tissue pathology, assess vertebral marrow, and assess the Low Back Pain spinal canal patency. MRI lumbar spine without IV contrast is most useful in the evaluation of suspected CES, multifocal deficit, or progressive neurologic deficit because of its ability to accurately depict soft-tissue pathology, assess vertebral marrow, and assess the spinal canal patency. A prospective cohort study by Bell et al [41] recommends urgent MRI assessment in all patients who present with new-onset urinary symptoms in the context of LBP or sciatica.