Cauda Equina Syndrome (CES) is a rare condition which, even in the presence of prompt surgical decompression, can have devastating consequences for patients in terms of bladder and bowel dysfunction. The aim of this project was to develop a post-operative pathway for the assessment and management of bladder and bowel dysfunction in patients with CES. Beaumont Hospital performs a high volume of spinal surgeries. A small number are lumbar decompression surgeries due to CES. While sphincter function is routinely screened by a physiotherapist post-operatively, to date there has been no protocol in place for assessment and management of bladder and bowel dysfunction in this population. This project was carried out in collaboration with consultants in urology and colorectal surgery, as well as clinical nurse specialists in both areas.Purpose and background:
Method:
To establish the demand, referral pathways, utility and patient satisfaction of a physiotherapy led post operative spinal surgery review clinic. From July 2014 to January 2015 a pilot physiotherapy led clinic was established. The following clinic data was collected: number of patients reviewed, surgical procedure, outcome of clinic assessment, numbers requiring further investigation, numbers requiring review in the consultant led clinic and adverse events. A patient satisfaction survey was also administered to all English speaking patients. Patients were asked to rate the ease of getting through to the service by phone, length of wait, time spent with the clinician, answers to questions, explanation of results, advice about exercise and return to activities, the technical skills of the clinician, their personal manner and their overall visit. Data was anonymised and inserted into an excel spreadsheet for analysis. Descriptive statistical analysis was undertaken.Objectives:
Methods:
