RecruitingObservational

Cauda equina syndrome early recognition study

This study, called CESER, is looking for a better way to spot Cauda Equina Syndrome (CES) early. CES is a rare but serious condition affecting the nerves at the bottom of the spine, which can lead to long-term problems if not treated quickly. Currently, it's hard for doctors in A&E to tell who really has CES. The study wants to find out if certain symptoms can help decide which patients are very unlikely to have CES. This will help make sure those who need an urgent scan get one, and reduce unnecessary scans for others, ultimately improving care and preventing delays.

At a glance

Status

Recruiting

Sponsor

University of Oxford

Enrolment target

2,000

Start

01 Apr 2026

Estimated completion

01 May 2027

Cauda equina syndrome (CES)

What is this study about?

Cauda Equina Syndrome (CES) is a rare but serious condition that affects the nerves at the very bottom of your spine. Think of these nerves like the wires sending messages to and from your legs, bladder, and bowels. If these nerves get squashed, it can cause problems like lower back pain, numbness around your bottom, and difficulty controlling your bladder or bowels. If not treated quickly, it can lead to lasting issues like not being able to move your legs properly, or permanent problems with bladder and bowel control.

Because CES is so serious and needs fast treatment, doctors in A&E often worry about missing it. However, it's also very rare, so many people who come to A&E with back pain don't actually have CES. This means that sometimes, people have to wait a long time for special scans, or doctors struggle to decide who needs one straight away. The main goal of this study is to help doctors in A&E make quicker and more accurate decisions about who might have CES.

The CESER study wants to figure out if there's a particular pattern of symptoms that can help tell us if someone is very unlikely to have CES. By understanding this better, we hope to make it easier for doctors to quickly identify patients who really need an urgent MRI scan and treatment, and to avoid unnecessary scans and stress for those who don't. This will help improve care for everyone who comes to A&E with symptoms that could be related to CES.

Key takeaways

The study helps A&E doctors better diagnose a serious condition called Cauda Equina Syndrome (CES).
It aims to improve how quickly and accurately patients are assessed for CES.
Participation involves answering short questionnaires about your symptoms.
Your medical treatment will not be changed or affected by joining the study.
Information from this study will help future patients with similar symptoms.
You can withdraw from the study at any time without it affecting your care.

Who may be eligible?

The study is looking for adults aged 18 or over. You might be able to join if a doctor suspects you have Cauda Equina Syndrome (CES) and thinks you need an MRI scan to check. You must also be able to understand what the study involves and agree to take part.

You cannot take part if you've already had your MRI scan for CES before a doctor assessed you for the study. You also can't join if doctors suspect you have a broken spine, or if there's a reason you wouldn't be able to properly take part in the study or follow-up, such as if your doctors expect you to live for less than 12 months.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you 18 years old or older?
Has a doctor recently suspected you might have Cauda Equina Syndrome (CES)?
Have you been told you need an MRI scan to check for CES?
Have you *not* had your MRI scan for CES yet?
Are you able to understand and agree to take part in the study?

Answer every question to see your result.

What does participation involve?

If you decide to take part in this study, you'll first be asked to answer a few short questionnaires on a computer or tablet. These questions will be about your pain, any changes in sensation, and how your bowel and bladder are working. This usually takes about 10-15 minutes.

As part of your usual care, you'll still have an MRI scan, and your doctor will discuss your treatment plan based on the results. If you are diagnosed with CES, the study team will contact you again by email or text message after 6 weeks, then 6 months, and finally 12 months. Each time, you'll be asked to complete similar short questionnaires about your pain, bowel and bladder function, and your general quality of life. If you can't use a computer, they can call you or send paper questionnaires.

If you are not diagnosed with CES, you won't be asked to complete any more questionnaires. However, the study team will look at your hospital notes after 12 months to see if you had any other related diagnoses or treatments. You might also be asked if you'd be happy to talk to another researcher about your experience of being checked for CES, but this is completely optional and won't affect your treatment or participation in the main study.

Potential risks and benefits

There isn't a direct personal benefit for you by taking part in this study. However, the information gathered will be very helpful for doctors to improve how they diagnose CES for future patients. Taking part won't change the medical care you receive, so there are no extra risks involved in your treatment. Some people might find answering questions about their symptoms upsetting. If this happens, the study team will suggest you take a break and continue later. You are free to withdraw from the study at any time without giving a reason, and this will not affect your medical care.

Locations (12)

John Radcliffe Hospital
Approximate
Oxford, England
Royal Liverpool University Hospital
Approximate
Liverpool, England
Airedale General Hospital
Approximate
Keighley, England
St Thomas' Hospital
Approximate
London, England
Cambridge University Hospitals NHS Foundation Trust
City only
Cambridge, England
Betsi Cadwaladr University Lhb
City only
Bangor, Wales
Lothian
Approximate
City of Edinburgh, Scotland
University Hospitals Coventry and Warwickshire NHS Trust
City only
Coventry, England
Kettering General Hospital Laboratory
City only
Kettering, England
Manchester University NHS Foundation Trust
City only
Manchester, England
Freeman Road Hospital
Unverified
Newcastle upon Tyne, England
Kings Mill Hospital
Unverified
Sutton-in-ashfield, England

Common questions

What is Cauda Equina Syndrome (CES)?

It's a serious condition affecting the nerves at the bottom of your spinal cord, which can cause problems with your legs, bladder, and bowels.

Why is this study important?

It aims to help doctors in A&E quickly figure out who has CES and who doesn't, so people get the right scans and treatment faster.

Will my treatment change if I join the study?

No, taking part in the study will not affect the medical care or treatment you receive for your condition.

How much time will I need to commit?

Initially, about 10-15 minutes for questionnaires. If you have CES, you'll have three more 10-15 minute follow-ups over a year.

Can I stop taking part if I change my mind?

Yes, you can leave the study at any time without giving a reason, and it won't affect your medical care.

How to find out more

Kylea Draper- Kadoorie

ceser@ndorms.ox.ac.uk +44 01865 223126 (Mon, Tue and Thu Only), +44 07392165324 (Wed and Fri Only) Official trial record

Always speak to your GP or specialist before deciding to take part in a study.