Cauda Equina Syndrome

Cauda Equina Syndrome

A debilitating ailment caused by other spinal conditions, cauda equina syndrome occurs when the nerves of the cauda equina are pinched. It causes low back pain and numbness in the lower extremities.

What is Cauda Equina Syndrome?

  • Cauda equina syndrome is an uncommon spinal condition that develops from a spinal abnormality severely compressing nerve roots. The condition affects the cauda equina, which are a bundle of nerve roots located at the lower end of the lumbar spine section.
  • Latin for "tail of horse", the cauda equina has many bundles of nerve roots that resemble a horse's tail. Strong compression of the spinal cord and/or spinal nerve roots at the level where the cauda equina is located may lead to severe low back pain and other incapacitating symptoms.
  • Cauda equina syndrome is not an indication of another condition; it is a condition.
  • Mild cases of cauda equina syndrome may mimic symptoms from sciatica and lead to misdiagnoses. This may be troublesome for these patients, as further nerve damage may result in permanent debilitation.
  • Most cases of cauda equina syndrome require surgical treatment as soon as possible, or else lasting nerve damage may result in permanent paralysis of the legs and/or incontinence.

What are the symptoms of it?

  • Severe pain that comes on suddenly and does not go away within days
  • Low back pain that may be sharp, dull, shooting, aching, burning, dull, deep, and/or throbbing
  • Pain, numbness, and/or tingling in the buttocks and/or lower extremities
  • Numbness and/or tingling sensation felt in the areas of the body that would touch a saddle when sitting on a horse, also known as saddle anesthesia
  • Weakness, discomfort, and/or stiffness in the legs
  • Difficulty walking and keeping balance, as well as clumsiness
  • Bladder and/or bowel incontinence
  • Abrupt sexual dysfunction

What causes it?

Cauda equina syndrome is caused by any spinal condition that results in pinching of the nerves that make up the cauda equina. The condition may occur from any amount of nerves in the cauda equina being compressed. A severe lumbar herniated disc, spinal stenosis, and a spine injury may cause cauda equina syndrome. In rare cases, it may occur from a spinal infection, tumor, or birth defect.

How do you treat it?

The majority of patients with cauda equina syndrome require surgery to relieve the pressure on the nerves. This surgery should be done as soon as possible to prevent permanent damage. Unlike other conditions where conservative methods of treatment are attempted before surgery, with cauda equina syndrome, surgery is required first and then conservative treatments are tried.

The surgery to decompress the nerves must be done in a timely matter to prevent permanent paralysis of the legs, bladder and/or bowel incontinence, and other symptoms. The surgery performed depends on the symptom that caused cauda equina syndrome. For example, a discectomy may be performed for a lumbar herniated disc, and a spinal fusion surgery may be done for spinal stenosis and other conditions causing spine instability.

Even with prompt surgery, patients still may not retrieve full function. This depends on the amount of damage occurred. Patients may need to participate in conservative methods of treatment to efficiently live with cauda equina syndrome. Some of these treatments may include: physical therapy, hot and cold compresses, pain and/or anti-inflammatory medications, and steroidal injections.

If you would like information on treating cauda equina syndrome, and you feel you may be a candidate for a spine procedure, please send us your MRI scan here and we will review it for free.