Red Flags for Serious Spinal Pathology
When assessing a patient with spinal or limb pain, it is important to look for the presence of red flags, which may indicate serious underlying spinal pathology. If a serious condition is suspected, an urgent or emergency referral to your local spinal unit may be necessary, although a degree of clinical judgement is required when referring these cases.
Red Flags for Spinal Metastases
- Constant severe mechanical spinal pain
- Progressive spinal pain despite conservative treatment
- Persistent thoracic spine pain
- Patient age under 20 or over 50 with back pain for the first time
- Personal or family history of cancer
- Unexplained weight loss, cachexia, loss of appetite
- Structural deformity of spine
Red Flags for Spinal Infection
- Constant severe spinal pain which continues when supine. May worsen at night
- Unexplained fever, malaise or lethargy
- Recent bacteraemic infection, UTI, or endoscopic procedure
- Immune suppression risk factors: Diabetes, alcohol dependence, IV drug misuse or HIV
- Structural deformity of spine
Red Flags for Cauda Equina Syndrome
- Recent onset urinary retention with overflow incontinence
- Recent onset faecal incontinence
- Bilateral sciatica, leg numbness or weakness
- Progressive bilateral neurological deficit in the legs
- Perineal / saddle anaesthesia
- Lax anal sphincter
Red Flags for Spinal Fracture
- History of fall or spinal trauma
- History of osteoporosis
- Long-term steroid medication
CONTACT US
- f: 0117 9059 887