From the neurosurgical point of view, these include (See referral guidelines):<\/p>\n\n\n\n
Red flags include:<\/strong><\/p>\n\n\n\n Foot drop is a symptom of a variety of disorders and can be classified as either a central or peripheral problem. Peripheral problems can be differentiated into peripheral neuropathy or radiculopathy.<\/p>\n\n\n\n Foot drop from a spinal source causes weakness due to compression of L4 and\/or L5 nerve roots causing weakness predominantly in the tibialis anterior muscle and characteristic slapping gait (high stepping gait).<\/p>\n\n\n\n Referral- Discuss with on call neurosurgical registrar via switchboard 0131 242 1000<\/p>\n\n\n\n Consider the possibility of spinal metastases or MSCC in people who have the following features and immediately follow MSCC pathway if patient has cancer (or strongly suspected) or is under follow up from a previous cancer and one of the following:<\/p>\n\n\n\n Lothian Metastatic Spinal Cord Compression Pathway –\u00a0<\/strong>Available at:\u00a0MSCC Intranet Page<\/a><\/p>\n\n\n\n Please Note: Separate documents available for NHS Lothian & NHS West Lothian – Please select appropriate depending on work area.<\/p>\n\n\n\n Referral\/ action- see detail within RefHelp Metastatic Spinal Cord Compression Page<\/a><\/p>\n\n\n\n Referral- Discuss with on call neurosurgical registrar via switchboard 0131 242 1000<\/p>\n\n\n\n Such as discitis, vertebral osteomyelitis, or spinal epidural abscess.<\/p>\n\n\n\n Red flags include:<\/strong><\/p>\n\n\n\n Referral- Discuss with on call neurosurgical registrar via switchboard 0131 242 1000<\/p>\n\n\n\n Red flags include:<\/strong><\/p>\n\n\n\n If clinical assessment by GP leads to a very strong suspicion of suspected underlying malignancy, consider recommendations and referral options GP Access to CT for Suspected Cancer (No Clinically Obvious Primary) \u2013 RefHelp<\/a><\/p>\n\n\n\n Clinical features of Intermittent Claudication<\/strong> see guidance on Intermittent Claudication RefHelp page<\/a><\/p>\n\n\n\n Clinical features of\u00a0Abdominal Aortic Aneurysm<\/strong>\u00a0see guidance on\u00a0Abdominal Aortic Aneurysm RefHelp page<\/a><\/p>\n\n\n\n See Neurology \u2013 RefHelp<\/a> for further referral guidance and support<\/p>\n\n\n\n <\/p>\n\n\n\n Do not refer patients to MSK Physiotherapy who have presence of significant red flags\/ suspicion of a serious spinal condition or have suspected inflammatory spinal pain.<\/p>\n\n\n\n Detail as per who to refer section<\/p>\n<\/div><\/div>\n\n\n\n <\/p>\n<\/div><\/div>\n\n\n\n For reliable, trustworthy patient advice and information direct patients to:<\/p>\n\n\n\n NHS Lothian MSK Self Help Resources Webpage<\/a><\/p>\n\n\n\n NHS Inform – Back Problems Information<\/a><\/p>\n\n\n\n NHS Inform – Exercises for back pain<\/a><\/p>\n<\/div><\/div>\n<\/div>\n","protected":false},"excerpt":{"rendered":" From the neurosurgical point of view, these include (See referral guidelines): Suspected cauda equina syndrome Red flags include: Acute foot drop Foot drop is a symptom of a variety of disorders and can be classified as either a central or peripheral problem. Peripheral problems can be differentiated into peripheral neuropathy or radiculopathy. Foot drop from<\/p>\n","protected":false},"author":6,"featured_media":0,"parent":4099,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"categories":[1235],"class_list":["post-23362","page","type-page","status-publish","hentry","category-https-apps-nhslothian-scot-refhelp-serious-lumbar-spine-conditions-red-flags"],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"rttpg_featured_image_url":null,"rttpg_author":{"display_name":"heatherlevy","author_link":"https:\/\/apps.nhslothian.scot\/refhelp\/author\/heatherlevy\/"},"rttpg_comment":0,"rttpg_category":" https:\/\/apps.nhslothian.scot\/refhelp\/Serious lumbar spine conditions-(Red Flags)<\/a>","rttpg_excerpt":"From the neurosurgical point of view, these include (See referral guidelines): Suspected cauda equina syndrome Red flags include: Acute foot drop Foot drop is a symptom of a variety of disorders and can be classified as either a central or peripheral problem. Peripheral problems can be differentiated into peripheral neuropathy or radiculopathy. Foot drop from","_links":{"self":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/23362","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/users\/6"}],"replies":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/comments?post=23362"}],"version-history":[{"count":3,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/23362\/revisions"}],"predecessor-version":[{"id":24299,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/23362\/revisions\/24299"}],"up":[{"embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/pages\/4099"}],"wp:attachment":[{"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/media?parent=23362"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/apps.nhslothian.scot\/refhelp\/wp-json\/wp\/v2\/categories?post=23362"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}\n
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Acute foot drop<\/h4>\n\n\n\n
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Suspected metastatic spine cord compression (MSCC)<\/h4>\n\n\n\n
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Deteriorating lumbar radiculopathy with motor deficit grade 3 or less (Oxford scale)<\/h4>\n\n\n\n
Suspected infection<\/h4>\n\n\n\n
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Suspected malignancy<\/h4>\n\n\n\n
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Suspected vascular symptoms<\/h4>\n\n\n\n
Widespread neurology- features not in keeping with lumbar radiculopathy<\/h4>\n\n\n\n
<\/ul>\n
Who can refer:<\/strong><\/h4>\n\n\n\n
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Who to refer:<\/strong><\/h4>\n\n\n\n
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Who not to refer:<\/strong><\/h4>\n\n\n\n
How to refer:<\/strong><\/h4>\n\n\n\n