Objectives: Although long term disability may be a consequence of cauda equina syndrome
(CES), the evidence base for the effect of rehabilitation or different rehabilitation strategies is
lacking. Our aim was to understand long term neurological deficits (understood as
rehabilitation needs) and current rehabilitation provision for patients with CES.
Methods: We retrospectively analysed data from a large UK wide cohort of CES patients
presenting between 1st June 2018 and 31st May 2019. Rehabilitation referrals and attendance
were described, and symptoms at discharge and one year were identified as potential targets
for rehabilitation.
Results: Physiotherapy was the most common inpatient rehabilitation service accessed
following surgery for CES (572/610, 94%). Few patients were referred to specialist spinal
rehabilitation services at discharge (49/608, 8%). At one year follow up there were high rates
of residual symptoms (motor (66%), bladder (20%), bowel (17%), and sexual dysfunction
(13%)). There was a significantly higher level of ongoing bladder dysfunction in females (27%)
compared with males (11%) despite similar levels at presentation (females 84% vs males 82%).
Conclusion: Referral to specialist spinal rehabilitation following CES surgery is not routine in
the UK but a notable proportion of patients have ongoing symptoms at one year following
surgical decompression. Prospective studies of rehabilitation strategies following surgery for
CES are needed to guide treatment decisions and optimise post-surgical outcomes.