مريض بألم ظهر شديد صار عنده احتباس بول وتنميل في منطقة السرج حول الشرج وضعف في الرجلين. ما التصرف؟

A client with severe back pain develops urinary retention, saddle numbness around the anus and leg weakness. What is the action?

1. Urinary catheter only and discharge
2. Urgent referral for cauda equina syndrome
3. Analgesia and a week of bed rest at home
4. Outpatient physiotherapy in a month

Answer: B) Urgent referral for cauda equina syndrome. Urinary retention, saddle anaesthesia and leg weakness with back pain indicate cauda equina compression, a surgical emergency to prevent permanent paralysis and incontinence.