A 55-year-old male presents with acute onset of severe lower back pain radiating down both legs, bilateral foot drop, and urinary retention. He has sa...

Question

A 55-year-old male presents with acute onset of severe lower back pain radiating down both legs, bilateral foot drop, and urinary retention. He has saddle anaesthesia. MRI shows a massive central disc herniation at L4/L5. How quickly should surgical decompression ideally occur?

Accepted Answer

Within 24 hours and ideally as soon as possible - complete cauda equina syndrome with urinary retention has the worst prognosis for bladder recovery with delayed surgery

Answer

Within 72 hours

Answer

Surgery is not beneficial once urinary retention has developed

Answer

Within 1 week is acceptable

Answer

Elective surgery within 6 weeks

uk-dipimc MCQ (SBA): CES - Surgical Timing

A 55-year-old male presents with acute onset of severe lower back pain radiating down both legs, bilateral foot drop, and urinary retention. He has saddle anaesthesia. MRI shows a massive central disc herniation at L4/L5. How quickly should surgical decompression ideally occur?