Cauda Equina Syndrome

What is it?

The term cauda equina refers to the sac of nerves and nerve roots below the spinal cord in the lumbosacral spinal canal, compression of which leads to the Cauda equina syndrome. It is a rare but serious disorder, and a medical emergency is often required, primarily because of the bladder and bowel dysfunction and even permanent paralysis in the muscles of one or both legs.

Cauda equina syndrome is commonly caused by a disc herniation in the lumbar spine, which usually occurs with advanced age or can be caused by a spinal injury.

Cauda equina syndrome can also be caused by trauma, a spinal tumor, spinal stenosis, or a severe infection. In rare cases, spinal stenosis and vertebral fractures from osteoporosis can lead to cauda equina syndrome.

Symptoms

Cauda equina syndrome can cause a variety of symptoms, including severe low back pain, bladder dysfunction such as urinary retention or incontinence, bowel incontinence, difficulty walking, loss or reduction of reflexes, and saddle anesthesia (inability to feel anything in the body areas that would sit on a saddle). Exact symptoms and their severity depend on which nerve root(s) are affected and the degree to which they are compressed.

Diagnosis

Symptoms of the Cauda equina syndrome may be similar to the symptoms of the several other conditions, and they may vary in intensity and evolve slowly over time.

If a patient presents with symptoms associated with cauda equina syndrome, a magnetic resonance imaging (MRI) and myelogram are used to confirm the diagnosis.

Treatment

Cauda equina syndrome may require timely decompression surgery to reduce the pressure on the nerves. Following the surgery, bladder function may take longer to improve than muscle function.