What is Cauda Equina Syndrome?
Cauda equina syndrome is a medical emergency. The fluid that surrounds your spinal cord is called cerebrospinal fluid. This is what is extracted in a spinal tap – that can then be tested for infection, etc. Your spinal cord goes down to your second lumbar vertebrae, then it stops. But you have a bunch of nerves that keep going down further. This bunch of nerves is called the cauda equina. Cauda equina means horse’s tail. This bunch of nerves looks like a horse’s tail. This is where they do a spinal tap because there’s no spinal cord there.
When dealing back pain or other spinal issues, if the cauda equina has a problem, you need to treat this as a medical emergency. It’s called Cauda Equina Syndrome. Patients who have low back pain will always be asked “are you having any problems urinating, defecating, any numbness when you wipe after you use the bathroom?” The cauda equina controls those things and if it is pressure is placed on this bundle of nerves by a disc or something else. Again, this is an emergency surgery situation.
What Causes Cauda Equina Syndrome
The cause of Cauda Equina Syndrome is generally a severely herniated disc that is placing pressure on this bunch of nerves. There may also be an obstruction within the spinal column unrelated to a herniated disc that may be causing Cauda Equina Syndrome. Some causes may be:
- Spinal lesions, infection, or inflammation
- Developmental abnormalities present from birth
- Traumatic injuries to the low back
- Complications after low back surgery
- Spinal stenosis
- Spinal hemorrhages
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Cauda Equina Syndrome Symptoms
The symptoms of Cauda Equina Syndrome may be similar to other diagnoses and an immediate consultation with a doctor is mandatory. Cauda equina symptoms may be any or all of the following:
- Severe low back pain
- Trouble beginning urination
- Losing control of bowel or bladder
- “saddle anesthesia” meaning a loss of sensation to the area of your body that would be in contact with a saddle when riding a horse
- Sexual dysfunction
- Weakness and sensation loss in the legs
If You Are Experiencing Symptoms, Schedule an Appointment Dr. Burke Orthopedics Immediately.
Treatments for CES
Cauda equina is a medical emergency requiring immediate decompressive surgery on whatever obstruction is placing pressure on the Cauda Equina in order to prevent the chance of permanent damage. If left untreated, cauda equina syndrome may progress to a level of permanent loss of bowel or bladder control leading to incontinence. If you experience any of the warning signs mentioned above, you must consult with a surgeon immediately. It is generally accepted that there is up to a 48-hour window from the onset of these symptoms that if the pressure on the nerves is reversed within that time, a high likelihood of full recovery is possible. Even after the 48-hour window though, significant improvements in function are still likely. The surgery commonly chosen to treat this condition is called a Lumbar Laminectomy. A Lumbar microdiscectomy may also be performed. The amount and extent of recovery that a patient will experience after surgery varies from patient to patient. With prompt medical attention, your chances of permanent damage decrease significantly.