24/7 access to MRI scans for Cauda Equina Syndrome

Tuesday 19 February 2019

The Royal College of Radiologists (RCR) has responded to calls for round-the-clock local hospital scanning to spot urgent spinal cord compression, as raised by spinal surgeons and included in a recent spinal services review.

RCR Vice President for Clinical Radiology Dr Caroline Rubin said:

“The Society of British Neurological Surgeons and the British Association of Spine Surgeons state that due to the urgency and difficulty diagnosing Cauda Equina Syndrome (CES), there should be a low threshold for putting suspected cases forward for a magnetic resonance imaging (MRI) scan and that MRI scanning must be available 24/7 at the patient’s local hospital

“We agree that suspected cases of CES should have access to an immediate MR scan, following review by a senior clinician. However most district general hospitals do not have the staffing required to support delivery of a 24/7 MRI scanning service.

“Ideally, there would be 24/7 imaging and neurosurgery expertise available to deal with these critical cases in any hospital, but that would require extra funding and NHS staff capacity.

“To mitigate a patient ‘postcode lottery’, hospitals will have to form ‘hub and spoke’ emergency networks. Neighbouring hospitals will need to have clear assessment and transfer protocols in place to ensure suspected CES cases can be transferred to a hospital that has capacity to deliver a 24/7 MRI service, scanned, reported and potentially taken straight to surgery.”