MRI Lumbar Spine — Cauda Equina Syndrome [ED/INPATIENT]
MRIBASS Standards of Care 2018RCR CIB February 2023GIRFT National CES Pathway 2023v2.0 · March 2026
Immediate
EDInpatient
CES clinical features — justify emergency MRI if ANY present
Immediate— ANY of the following
- Bladder dysfunction: urinary retention, incontinence, loss of urge to void
- Bowel dysfunction: incontinence, constipation of new onset
- Saddle sensory disturbance (perianal/perineal region)
- Bilateral lower limb weakness or radiculopathy
- Sexual dysfunction of new onset
CES classification (GIRFT 2023)
— Classification for documentation and communication — does not change urgency of MRI
- CESS (suspected): symptoms but incomplete/uncertain signs
- CESI (incomplete): confirmed CES without retention
- CESR (retention): confirmed CES with urinary retention
Notes
Alert
24/7 on-site MRI mandatory at all acute hospitals for suspected CES (RCR CIB 2023)
RCR CIB February 2023Information
Protected first MRI slot each day for suspected CES recommended
Warning
Do NOT delay MRI for CES — surgical decompression outcomes are time-dependent
Change Log
v2.02026-03-08New protocol — cauda equina syndrome emergency MRI pathway