What is cauda equina syndrome?

Cauda equina syndrome is an uncommon condition affecting the bundle of nerve roots, called cauda equina, at the lumbar (lower) end of the spinal cord. Though back and leg discomfort are frequent and usually resolve without surgery, cauda equina syndrome is a surgical emergency.

The spinal cord and the lumbar nerve roots are the lower parts of the brain. The transmission and reception of signals between the lower limbs and pelvic organs occur through them. When these nerve roots, that is the lumbar spine, are compressed or squeezed, there is loss of sensation and movement leading to what is termed cauda equina syndrome. It particularly damages those nerve roots responsible for bowel and bladder control.

Surgery must be done for the treatment of cauda equina syndrome. If the pressure is not immediately relieved, there can be numerous problems that could arise, such as:

• Infinite paralysis
• Bowel or bladder control impeded
• No sexual arousal
• Chronic pain

Even though the best results come from early treatment for cauda equina syndrome, some patients do not have full recovery, even with early treatment.

There are several types of cauda equina syndrome.

Cauda equina syndrome has two forms:

• CES-I, or incomplete cauda equina syndrome, is marked by a loss of urgency or sensation in the intestines and bladder. This means you cannot feel when you need to urinate or poop. Forty percent of people who have cauda equina syndrome suffer from this.
• CES-R complete cauda equina syndrome: This results in incontinence or retention of urine and/or bowel. Incontinence is the loss of control of urination or bowel movements; retention is when a person can neither urinate nor have a bowel movement. Approximately 60% of the patients who are diagnosed with cauda equina syndrome are affected.

What are the symptoms of cauda equina syndrome?

Cauda equina syndrome symptoms can be:

• Pain in the legs (sciatica) and/or lower back.
• Weakness in the legs.
• Paraesthesia is the medical term for numbness or burning, prickling, or tingling sensations in the butt, hip, inner thighs, and backs of your legs.
• Incontinence of the faeces or urine.
• Retention of urine.
• If you have any of these symptoms, seek the ER immediately.

What causes cauda equina syndrome?

The cause of cauda equina syndrome is compression, which occurs when something presses against the cauda equina nerve roots at the base of your spinal cord (L1 to L5).

Compression of the cauda equina is most commonly caused by a herniated lumbar disc.

The following are other common causes of nerve root compression:

• Infection (meningitis, discitis, or epidural abscess).
• Injury to the lower back.
• Stenosis in the lumbar spine.
• Complications after surgery on the lumbar spine.
• Epidural haematoma in the spine.
• Bleeding in the spine.
• Tumours or lesions in the spine.

What side effects may cauda equina syndrome produce?

Nerve damage might result in cases where treatment is withheld or applied later, a feature that will contribute to some long-term complications that are related to cauda equina syndrome as mentioned below.

• Sexual relationship dysfunction.
• Loss of control of the bowels or bladder.
• Paralysis of the legs.

How is the diagnosis of cauda equina syndrome performed?

A medical professional will determine cauda equina syndrome after medical tests, neurological examination, and physical examination. After considering your medical history, your provider will assess you for your ability to:

• Stand up.
• Sit down.
• Toe walk.
• Be aware of your environment.
• Leverage forward.
• Leverage back.
• Leverage your way from side to side.
• Leverage your legs when you are lying down.

Your doctor can know more about you with this information.

• Stability.
• Sensations.
• Strength.
• Reflexes.
• Alignment.
• Range of motion.

To check your anal muscles, your doctor may also perform a rectal exam.

What tests are used to diagnose cauda equina syndrome?

To see your bones, nerve roots, and spinal cord, your doctor may order the following imaging tests:

• MRI stands for magnetic resonance imaging.
• CT scan (computed tomography).
• Myelogram.

How is cauda equina syndrome treated?

Acute cases of cauda equina syndrome require emergency surgery. A surgeon will move anything that is compressing your nerve roots so that they can heal. This is known as a lumbar laminectomy.

Your provider may have you take medicines to help with bowel and bladder control after surgery. You will likely need to self-catheterize to drain your bladder. You will also have physical therapy after surgery to get your strength back.

Participating in occupational therapy to help you complete everyday activities.

How soon after treatment will I feel better?

Everyone heals at different times. It might be almost right away in terms of recovery from surgery in regards to returning to feeling like your butt and legs are once again functioning and can walk as needed. At least you cannot run or hike immediately, regardless of how simple this may be, while your body is healing and the stitches work themselves out from within. There might be anywhere from weeks, months, even years before returning full control to the bladder as if nothing occurred during surgery.

Can cauda equina syndrome be prevented?

Not all of the causes of cauda equina syndrome can be avoided. However, the most common cause that can happen to anyone is a herniated disc, which you may be able to lower your risk of. Try these suggestions:

• Steer clear of high-heeled footwear: Your spine may be misaligned by these kinds of shoes.
• Quit smoking: Cigarettes and other tobacco may also weaken your discs.
• Get stronger muscles: Discuss with your physician what exercise you can perform in order to develop stronger muscles on your abdominal wall and the muscles of the back.
• Lift properly: You should lift large items with the knees and lift them as you bend rather than bending over.
• Maintain correct posture: Keeping good posture will reduce strain in your back, and on your spine.
• Stretch: Periodically stretch your body, particularly after extended periods of sitting.

How long may a person with cauda equina syndrome expect to live?

Your life expectancy will not be affected by cauda equina syndrome. However, your quality of life can be affected by the symptoms. In case you start experiencing symptoms, seek help right away.

When should I see a physician?

If you experience any of the following signs of cauda equina syndrome, you need to go to the emergency department right away:

• Pain in your lower back, either sharp or chronic
• Difficulty urinating or defecating
• A problem walking.
• You may be feeling numbness, or other changes in your bottom and upper thighs.

Your prognosis for long term effects is best if you see a doctor promptly.

What questions should I ask my doctor?

• What type of cauda equina syndrome do I have?
• Is it chronic or acute?
• How soon must I have surgery?
• How long will the surgery take?
• How long will I stay in the hospital after surgery?
• Do I have a herniated disk?

Why Tender Palm Super-Speciality Hospital for cauda equina syndrome?

Tender Palm Hospital, owned by doctors, is renowned for attracting the most experienced professional in the country, with the finest neurologist and neurosurgeons specialized in cauda equina syndrome. Tender Palm stands out as the premier Neurology hospital in Lucknow, India. Boasting cutting-edge infrastructure and advanced technology, Tender Palm ensures top-notch medical care for its patients.

To seek an expert consultation for any Neurology condition

Call us at +91-9076972161
Email at care@tenderpalm.com

Request a Call Back