Cauda equina syndrome

Acute loss of neurological function in the nerve roots below the end of the spinal cord (usually below abouot L1, L2).

Essentially, many of the things that cause cauda equina syndrome are incredibly serious. The damage, if untreated, can become permanent.

For every cause, pressure is put on or direct damage is done to the nerves in the cauda equina.

Tumour - this puts pressure on the cauda equina and is often a metastasis
Trauma - direct damage to the nerves. Usually due to a prolapsed vertebral disc
Spinal stenosis - due to a number of causes, the spinal canal becomes smaller, putting pressure on the nerves within
Inflammation - things like Paget's disease of bone and ankylosing spondylitis get inflamed, putting pressure on the nerves.

Urinary and faecal incontinence - reduction in sphincter power
Saddle anaesthesia (losing feeling in the bits of you that would touch a saddle - genitals, perineum, anus. That sort of area.)
Lower motor neurone weakness - reduced power, tone and reflexes. Can lead to paralysis.
Back pain and leg pain - radicular pain (along a dermatome) down legs

The conus medullaris is just above the cauda equina (T12-L1). Lesions here tend to cause urinary retention and constipation.

MRI and CT scans are done to accurately pinpoint nature and site of lesion. Occasionaly, urodynamics is done.

Contents