Cauda Equina SyndromeCauda equina syndrome (CES) is a serious condition that affects the lower lumbar spinal nerve roots. The actual spinal cord ends in the lower thoracic or upper lumbar spine. After this point, the various spinal nerves branch off, forming the cauda equina, also known as the horse’s tail. These spinal nerve roots serve the neurological needs of the pelvis and the lower limbs.
Sometimes, due to an injury, these nerve roots are compressed. If this compression is serious, it can affect the bladder, bowel or sexual functions.This condition is considered a medical emergency, since damage to these nerves may be permanent. Even if treatment is given immediately, the function of these organs may still suffer some lasting effects. Causes of CESAn injury to the lower spinal nerve roots can be caused by any type of severe trauma, infection, or tumor. One of the most common causes is from a herniated disc that compresses the spinal nerves. Auto accidents and falls are the 2 biggest reasons for acute cauda equina syndrome to occur. In cases of trauma, the expression may come on very suddenly. In cases of central spinal stenosis due to arthritic change, spinal curvature or vertebral misalignment, symptoms may be progressive and gradually build to reach an eventual terrible degree.Symptoms of Cauda Equina SyndromeSymptoms may be immediate, or may evolve and worsen over time.Severe lower back pain and sciatica typically begin the condition. Patients may not be able to stand or walk well or at all. Bladder or bowel problems. Symptoms may include the inability to prevent eliminating waste (incontinence), or the inability to eliminate at all (constipation). Diagnosis of CESDiagnosis is made through a physical exam. Muscle and neurological tests will be performed. X-rays might be ordered. If there is suspicion of cauda equina syndrome, then a spine MRI or CT scan will be the usual process of confirmation.Often, a cervical spinal stenosis condition will produce symptoms strikingly similar to CES and in these cases, the lumbosacral evaluations may come back clean. A cervical MRI is always recommended in these cases to recognize central canal narrowing in the neck (or even middle back in rare cases) which may be causative. Treatment of CESMost treatment is done by immediate surgical correction, to relieve nerve compression. The process can be minimally invasive, since only a small area is treated. Even with successful treatment, permanent damage may have been done to the nerves. This can leave a patient with permanent bowel, bladder or sexual dysfunction.Future prognosis typically relies much on the underlying source of CES to begin with. Arthritic bone issues respond better to surgery long-term than do disc pathologies. Meanwhile, spinal curvature and spondylolisthesis disorders are some of the most difficult to successfully treat using an operation. Recommendation for Cauda Equina SyndromeIf you have injured your lower back or show any symptoms of CES, seek immediate medical attention. This is a very serious condition that can leave lifelong effects that can drastically reduce your quality of life. Time is precious in this situation, so do not delay. Get to a hospital immediately! If drastic invasive treatment is recommended, consider inquiring about an immediate second opinion to be sure you are doing the right thing and not simply giving in to the incredible stress of the moment.Cauda Equina Syndrome to Back Pain 6/10/06 Revised 1/26/12 |
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