Clinical management of a Veteran with chronic scan-negative cauda equina syndrome: a case report.

OBJECTIVE

To describe the clinical presentation, diagnostic considerations, and safety-first course of chiropractic care for an adult male with chronic scan-negative cauda equina syndrome.

CLINICAL FEATURES: A 41-year-old male U.S. Veteran sought chiropractic care for progressively intensifying chronic low back pain and bilateral lower extremity pain along with progressive bladder dysfunction, groin hypoesthesia, and sexual dysfunction. The history and examination findings raised concern for cauda equina syndrome, but a same-day MRI and neurosurgery consult failed to yield surgical indications.

INTERVENTION AND OUTCOMES: Chiropractic care involved 8 visits over 10 weeks. Care focused on neurological monitoring and patient education along with soft-tissue therapy, flexion-distraction, and spinal manipulation. The patient reported improvements in pain, function, and neurological features following this course of care, and no adverse events occurred.

SUMMARY: This case emphasizes timely recognition of features associated with cauda equina syndrome and illustrates a cautious, multimodal approach to chiropractic co-management for an individual with scan-negative cauda equina syndrome.