Biomarkers in Nerve Compression and Cauda Equina Syndrome Study
Research type
Research Study
Full title
Biomarkers in Nerve Compression and Cauda Equina Syndrome Study
IRAS ID
335910
Contact name
Steven Crane
Contact email
Sponsor organisation
York & Scarborough Teaching Hospitals NHS Foundation Trust
Duration of Study in the UK
0 years, 6 months, 0 days
Research summary
Cauda equina syndrome (CES) is a rare condition caused by compression of the lumbosacral nerve roots. Symptoms include back pain, sciatica, loss of sensation in the saddle region, and bladder and bowel dysfunction. It is a neurosurgical emergency and delays to diagnosis and treatment can lead to permanent disability and medicolegal problems.
Clinical examination of patients has limited ability to exclude the diagnosis of Cauda Equina Syndrome, and most patients with any of these symptoms need emergency MRi to rule out CES. In a recent audit over a 2-month period at York ED, there were 123 lumbosacral spine MRi scans performed for patients presenting with potential cauda equina syndrome. Of these, only 7 patients had cauda equina syndrome.
Neuron-specific enolase (NSE) is a marker found in blood and cerebrospinal fluid, released from neuronal tissue upon damage. It is raised in patients with traumatic spinal cord injury, however, there are no studies looking at the levels of NSE in patients with potential cauda equina syndrome or nerve root compression.
This study wishes to measure NSE levels in blood in patients presenting to York Hospital Emergency Department with symptoms suggestive of Cauda Equina Syndrome. Eligible patients will be adults with the above symptoms where the assessing clinician feels an MRi is needed to exclude CES. The aim is to measure NSE levels in blood in such patients at presentation to the emergency department and to determine whether the level is related to the MRi findings.
This is a pilot study to see if this blood test has the potential, in future, to reduce the need for MRi scans. The study will be carried out over a 2 month period. Participants would undergo a blood test in addition to the standard assessment and treatment in A&E for this presentation.
REC name
London - City & East Research Ethics Committee
REC reference
23/PR/1415
Date of REC Opinion
13 Dec 2023
REC opinion
Favourable Opinion