EP 745 Spinal Patients at a DGH - Presentation, Management, and Specialist Referral Rates

Introduction and Aim

Spinal presentations require thorough assessment and when indicated, specialist discussion. Their management requires careful review and imaging. This study evaluated the prevalence of spinal patients by reviewing the presenting causes and specialist referral rates seen at a district general hospital (DGH).

Method

A retrospective review of the patients known to Trauma and Orthopaedics at a DGH in October 2025 was completed. The collected data included demographics, primary reason for presentation, imaging results, and final outcomes on discharge.

Results

A total of 270 patients were reviewed by trauma and orthopaedics in October 2025. 84/270 – 31.1% of total patients were seen for spinal presentations. 44/84 (52.4%) were seen for suspected cauda equina syndrome (CES), 31/84 (36.9%) patients were trauma presentations, 6/84 (7.1%) cases were for pain, and 3/84 (3.6%) cases were for suspected discitis.

27/84 (32.1%) of the spinal patients were referred to for specialist assessments, while the remaining 57/84 (67.9%) of presentations were managed locally. Emergency surgical intervention was needed for one patient, who was transferred for spine surgery. Another patient was seen urgently in the weekly hot spine clinic.

All patients received cross-sectional imaging in the form of CT or MRI.

Conclusions

In a single-centre review, almost half of spinal patients presented for suspected CES. The incidence of true CES through both clinical and radiological diagnosis was 1/44 (2.3%).

A majority of cases can be managed locally, with specialist input if required.