Abstract
BACKGROUND: Cauda equina syndrome (CES) treatment usually involves immediate consultation for surgical management. CASE PRESENTATION: We report the case of a 64-year-old woman exhibiting a 6-monthold progressive low back pain associated with motor weakness (right psoas and quadriceps), hyporeflexia (right patellar, left hamstring, and bilateral Achilles tendons) hypoesthesia on the L2-3 dermatome, and sexual and bowel dysfunction. The patient was referred for a neurosurgical consultation. Surgery was not considered at this time, and the patient was referred to the universitybased chiropractic clinic. OUTCOME AND FOLLOW-UP: After 22 treatments, the patient reported a self-perceived percentage of improvement of 80%, a verbal numeric pain-rating scale at 2/10 and a 22% Oswestry score. Her bowel dysfunction, sexual dysfunction, and perineal numbness were resolved. DISCUSSION: We aim to work in collaboration with surgical teams to conduct shared decisionmaking with patients and offer conservative care for CES if deemed safe and appropriate. Future research should contribute to the identification of CES cases that might benefit from conservative care when surgery is not considered an immediate option. JOSPT Cases 2022;2(4):189–195. Epub: 12 October 2022. doi:10.2519/josptcases.2022.10946
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