Cauda Equina Syndrome

Cauda equina syndrome is a severe neurological condition that is characterized by the compression and inflammation of nerves in the spinal cord. The spinal column consists of network of nerves----called the nerve roots----that diverge from the main spinal cord and transmit signals to and from the brain to help control organ functions and the movement of muscles. Cauda equina syndrome causes these nerves to become severely inflamed and compressed, which can lead to loss of muscle and organ control and even leg paralysis.

Significance

• The cauda equina is the area at the base of the spinal column from where the nerve roots diverge. The nerve roots become inflamed and compressed when the cauda equina spinal canal becomes too constricted. This constriction can generally be treated with proper care and does not have a debilitating effect on the body. But when the cauda equine becomes severely compressed it becomes dangerous and is termed cauda equine syndrome. Cauda equina syndrome is a very serious condition that can cause permanent nerve damage; therefore, it requires immediate surgery.

Symptoms

• The major symptoms of the syndrome are: pain in lower back (sciatica), pain in the legs, groin numbness, weakened lower body muscles and sluggish reflexes. It can also restrict the person's ability to initiate, stop or control urination. In some cases a person might not be able to urinate at all. Bowel movements are also disturbed, which can result in constipation and incontinence.

Causes

• There are a number of causes of cauda equina syndrome including: injury-induced trauma, herniated disk, stenosis of the spine, neoplasms (tumors of the spine), inflammation caused by other conditions (like Paget's disease), and spinal infections. A herniated disk is the cause in approximately 15 percent of sufferers. The spinal column is generally affected by tumors that develop in other organs and then spread out. Medical procedures done in the area around the spine can sometimes go wrong and result in cauda equina syndrome.

Treatment

• Cauda equina syndrome requires immediate surgery within 48 hours of the manifestation of the symptoms. The main purpose of the surgical procedure is to reduce the amount of compression in the spinal column by creating enough space for the nerves to operate properly. The secondary purpose of the surgery is removing the cause of the syndrome, for instance, the removal of a tumor or the herniated disk that is causing the compression. Although surgery is imperative, there is still some chance that the patient might not benefit from it.

Prevention

• The timely identification of symptoms and early diagnosis is the primary method of prevention. Cauda equina syndrome is not a frequent complication, but anyone feeling lower-back pain in conjunction with pain and weakness in the legs should immediately report to a doctor.