Cauda Equina Syndrome

Description

Cauda equina syndrome (CES) is a serious neurological disorder resulting from the compression of nerve roots in the lumbar spine. This condition often leads to motor, sensory, and autonomic dysfunctions. Common causes include large herniated discs, spinal stenosis, tumors, epidural abscesses, and traumatic injuries. Patients typically present with severe lower back pain, bilateral or unilateral radiculopathy, and sensory changes in the saddle area, along with bladder and bowel dysfunction manifesting as retention or incontinence, along with reduced lower limb reflexes and weakness.



CES is a medical emergency that necessitates rapid diagnosis and prompt surgical decompression, ideally within 48 hours, to minimize permanent neurological damage. Diagnostic challenges arise, hence thorough clinical assessment and a strong patient history are crucial. MRI is the gold standard for confirming CES, while bladder ultrasound may assess urinary retention. Timely referral to a spinal specialist is critical, as untreated cases risk severe complications. Overall, maintaining a high index of suspicion in patients with back pain and symptoms related to bowel, bladder, or sensory changes is vital, as many potential cases could lead to substantial legal repercussions if overlooked.

DOI: 10.1302/3114-251104

Specialties