| Diagnosis (and duration) | Timeframe | Timeframe for clinic review/surgery |
|---|---|---|
| Degenerative cervical cord compression (with or without signal change) and myelopathic symptoms | Timeframe: any (refer to motor radiculopathy below if applicable) | Review in clinic within 6 weeks - earlier for more severe cases (link) for surgery as soon as possible if moderate to severe mJOA score (Partibhan et al., 2019) Refer to motor radiculopathy below, if applicable |
| Acute motor radiculopathy <3/5 (with corresponding neural compression) | Circa 6 weeks or less | Refer to ED/SDEC same day: confirmed correlating neural compression: Surgery within 0-8 weeks (Macki et al., 2016; Masuda et al., 2020; Saeed et al., 2021; Song et al., 2022) |
| Sub-acute major motor radiculopathy <3/5 | Circa 8 weeks - 6 months | Clinic appointment within 6 weeks and surgery as early as possible (Mirza et al., 2025) |
| Chronic motor radiculopathy (any degree on Oxford scale) | Circa over 3 months | Clinic appointment within 6 weeks for consideration of lumbar decompression (link) |
| Chronic and severe lumbar spine stenosis with cauda equina compression and static/no new chronic CES symptoms | >14 days Patients with < 14 days OR deteriorating/new cauda equina symptoms - refer to ED (GIRFT, 2023) |
Clinic appointment within 6 weeks (link) Patients with < 14 days deteriorating or new CES symptoms and cauda equina compression on MRI – surgery as NCEPOD immediate to urgent surgery (link) |
| Radicular limb pain with correlating nerve root impingement/compression - no weakness | Under 6 months | Acute/severe sciatica: injection within 8 weeks of MDM (link) Chronic: next available appointment |
| Vertebral fragility fracture (osteoporotic) with normal neurological examination | Any | Within 72 hours for surgery as per GIRFT VFF pathway (link) |