Cauda Equina

What Is Cauda Equina Syndrome?

Cauda equina syndrome is a rare disorder that usually is a surgical emergency. In patients with cauda equina syndrome, something compresses on the spinal nerve roots. Patient’s may need fast treatment to prevent lasting damage leading to incontinence and possibly permanent paralysis of the legs.

CES affects a bundle of nerve roots called cauda equina (Latin for horse’s tail). These nerves are located at the lower end of the spinal cord in the lumbosacral spine. They send and receive messages to and from your legs, feet, and pelvic organs.

Causes of Cauda Equina Syndrome

CES occurs more often in adults than in children. But it can occur in children who have a spinal birth defect or have had a spinal injury.

These are the most common causes of cauda equina syndrome:

  • A severe ruptured disk in the lumbar area (the most common cause)
  • Narrowing of the spinal canal (stenosis)
  • A spinal lesion or malignant tumor
  • A spinal infection, inflammation, hemorrhage, or fracture
  • A complication from a severe lumbar spine injury such as a car crash, fall, gunshot, or stabbing 

Symptoms of Cauda Equina Syndrome

It may be hard to diagnose cauda equina syndrome. Symptoms vary and may come on slowly. They also mimic other conditions. If a patient presents with any of these symptoms, see your doctor right away:

  • Severe low back pain
  • Pain, numbness, or weakness in one or both legs that causes you to stumble or have trouble getting up from a chair
  • Loss of or altered sensations in your legs, buttocks, inner thighs, backs of your legs, or feet that is severe or gets worse and worse; you may experience this as trouble feeling anything in the areas of your body that would sit in a saddle (called saddle anesthesia)
  • Recent problem with bladder or bowel function, such as trouble eliminating urine or waste (retention) or trouble holding it (incontinence)
  • Sexual dysfunction that has come on suddenly

Diagnosing Cauda Equina Syndrome

If CES is suspected following a detailed history and physical examination, then an MRI will be arranged via the ED and Radiology Consultants. If positive the patient will then be referred to NBT.

Cauda Equina information cards can be found here translated into many different languages so if you have a patient who can’t understand your questions, this is a great resource.

This card is translated in to 30 different languages so that you don’t miss any crucial pieces of history

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