What Are the Symptoms of Cauda Equina Syndrome?

Cauda equina syndrome refers to a constellation of symptoms caused by compression of the terminal end of the spinal cord. Symptoms include loss of bowel or bladder control, impotence, loss of feeling to the perianal area, and partial paralysis of the lower limbs. This is a dangerous condition and should be treated immediately.

Anatomy

• The cauda equina (the name means "horse's tail") is the nerve complex comprised of the bottom of the spinal cord and the roots of the lowest spinal nerves. The nerve roots pass through the sacrum and form several nerves, including the sciatic, pudendal and pelvic splanchnic nerves. These nerves, in turn, connect the surrounding area to the spinal cord. The muscles of the leg, the anal sphincters and the genitalia are all connected to the cauda equina.

Causes of Cauda Equina Syndrome

• Cauda equina syndrome occurs when the nerve complex is compressed or injured. The most common cause is lumbar disc herniation. A tumor in the area can compress the spinal cord. Trauma to the pelvis or sacrum that compromises these nerves can also cause the syndrome.

Symptoms

• The symptoms of cauda equina syndrome may come on suddenly or progress slowly. The most prominent symptom is retention of urine. Incontinence of bladder and bowel are also common. Impotence and numbness of the perianal (or "saddle") area may occur. Patients may also present with paralysis of the hamstrings, gluteal muscles and piriformis.

Treatment

• Cauda equina syndrome should be treated at the first sign of symptoms. Surgical decompression of the spine through laminectomy or other procedure, if performed within 48 hours of the onset of symptoms, may resolve the condition completely. Resolution depends on how badly the nerves are damaged.

Note

• Anyone experiencing a sudden change to bladder or bowel control, especially if combined with loss of feeling in the genital area, should consult a qualified health practitioner immediately. The potential for permanent damage is great. Cauda equina syndrome combined with weight loss can be signs of spinal metastasis, and cancer must be ruled out.