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This article reviews the prevalence and clinical diagnosis of CES, the new national guidelines and management in primary care. The standard of care for doctors, the legal basis of national guidelines and an illustrative judgement are discussed. This new standard of care for GPs will make it easier for claimants to demonstrate a breach of duty of care and, because patients should be referred earlier (on the basis of symptoms not signs of CES), causation and quantum will be higher than for cases where MR imaging and surgery are delayed until the onset of objective signs.<\/jats:p>","DOI":"10.1177\/00258172251405164","type":"journal-article","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T05:04:51Z","timestamp":1768799091000},"page":"39-42","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Symptom-only cauda equina syndrome: A medicolegal assessment of new national guidelines"],"prefix":"10.1177","volume":"94","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0622-8853","authenticated-orcid":false,"given":"Nicholas","family":"Todd","sequence":"first","affiliation":[{"name":"Consultant Neurosurgeon and Medico-Legal Expert, Newcastle Nuffield Hospital, Newcastle upon Tyne, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2026,1,18]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1080\/02688697.2017.1297364"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.3171\/2019.12.SPINE19839"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.lanepe.2022.100545"},{"key":"e_1_3_2_5_2","unstructured":"National Spine Network. 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