Question

A 45-year-old man presents with low back pain and new urinary retention, saddle anaesthesia and bilateral leg weakness. He has reduced anal tone. What is the most appropriate next step?

Accepted Answer

Urgent MRI of the whole spine and neurosurgical referral

Answer

Prescribe NSAIDs and physiotherapy

Answer

Outpatient referral to pain clinic

Answer

Lumbar puncture to exclude infection

Answer

Start oral steroids and review in 1 week

Practice question

A 45-year-old man presents with low back pain and new urinary retention, saddle anaesthesia and bilateral leg weakness. He has reduced anal tone. What is the most appropriate next step?