Cauda Equina Syndrome Symptoms

 

 

Cauda Equina Syndrome Symptoms

 

Cauda Equina Syndrome, although uncommon, is a serous spine disorder. It is the result of compression of the Cauda Equina nerves, which are a bundle of nerves at the end of the spinal cord. The spinal cord ends between the L1 and L2 vertebral levels as a tapered structure called the conus medullaris (around the same level as your kidneys). Below the conus medullaris, nerves continue to extend down inside the spinal column in a group named the cauda equina (latin for horse's tail). The cauda equina includes the nerve roots of L2 to L5 and all the sacral and coccygeal nerves.

 

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What Causes Cauda Equina Syndrome

Cauda Equina Syndrome results from compression or swelling of the nerve roots of the cauda equina. This is usually due to conditions such as:

  • A severe ruptured spinal disc in the lumbar area (the most common cause)
  • Spinal tumour
  • Narrowing of the spinal canal (stenosis)
  • Infection or inflammation
  • Fracture, dislocation or haematoma (trauma)
  • Birth defect

Cauda Equina Syndrome is rare but has serious consequences and can cause devastating long-lasting neurological deficits. Prompt evaluation and urgent Magnetic Resonance Imaging assessment should be performed in all patients who present with back pain in conjunction with sudden onset of urinary or bowel symptoms or abnormal neurological findings consistent with cauda equina involvement.

 

Symptoms of Cauda Equina Syndrome:

  • Low back pain
  • Unilateral or bilateral sciatica
  • Saddle hypaesthesia or anaesthesia
  • Bowel and bladder disturbances. Typically, urinary manifestations begin with urinary retention and are later followed by overflow urinary incontinence.
  • Lower extremity motor weakness and sensory deficits
  • Reduced or absent lower extremity reflexes

The onset of Cauda Equina Syndrome can be either sudden (acute) within 24 hours or gradual over a period of weeks or months.

If patients with cauda equina syndrome do not receive treatment quickly, adverse results such as paralysis, impaired bladder, and/or bowel control, difficulty walking, and/or other neurological and physical problems can quickly arise. It is imperative to seek professional advice immediately if you are experiencing any of the above symptoms.

However, patients should be aware that acute cauda equina syndrome that results in permanent nerve damage is extremely rare.

 

Diagnosis and Treatment of Cauda Equina Syndrome

Cauda Equina Syndrome is diagnosed through an understanding of the patients history, physical examination, and medical imaging such as MRI, CT scans, and/or a myelogram.

Once diagnosed, Cauda Equina Syndrome is considered a medical emergency requiring immediate surgery to prevent permanent damage. Often the patient will require medication such as steroids to control inflammation, or antibiotics for an infection. The long term prognosis depends on a variety of factors, specifically how quickly surgery was performed after the onset of symptoms.

While it is generally thought that neurological damage caused by cauda equina syndrome is permanent, some studies have reported that long-term management may allow patients with initially poor prognosis following surgery to eventually regain a near-normal voiding of a bladder with little daily interruption.

 

If you have any questions, or would like to share your own experience, please leave us a comment below.

Also, if you have found this article helpful, please share it so we can help even more people! Thankyou.

 

 

One Comment

  1. I have had back issues since I was about 18 or so, slowly got worse over the years. I went to physios etc which were of little help. Occassionally I got anti-inflamitory medication. It got to the stage where my walking was affected and painful. One day I had to chase our little dog down the street and when I caught her (Jack Russell) I bent down to pick her up. The pain was severe and sudden. I hobbled back home and layed down for about an hour. I felt better until my toe hit the floor and the pain went up my leg like I had been shot. Got an ambulance to the ER and as it was a Saturday they just gave me enough pain meds to be able to walk. Went to the doctor on Monday who sent me to x-ray, the results came on Thursday and he sent me for a CT scan. Those results came the following Monday. Over the weekend all the symptoms mentioned in the article started to happen. The only thing that worked below my waist was my right leg! I went to the doctor for the CT results and told him about what was going on. He wrote a letter to the ER doctor and sent me there. A couple of hours later I was in another ambulance heading to the Royal Melbourne Hospital. They put me straight into a ward and at 8pm they brought the MRI team back (they had knocked off for the day) to scan me. I was in having emergency surgery at 11pm. Laminectomy & diskectomy L5 / S1…

    This was nearly 12 years ago. I still have trouble walking, bladder and bowel is mostly OK, I can’t straighten my left big toe. About 5 years after the surgery I realised I could flex my left calf muscle again, to a degree, and sort wiggle my toes. Most of the feeling is coming back slowly. The nurse in rehab told me after the surgery that if I had of left it any longer I would have been in a wheel chair the rest of my life. I still have issues, but the pain is gone and it could have ended a lot worse.

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