Cauda Equina Syndrome

What is it?

Cauda equina is Latin for horse's tail as it resembles the nerves in the lower part of the spine. Cauda Equina Syndrome (CES) is a spinal emergency and results from severe compression of all or most of the nerves below the spinal cord. If it is not treated early enough it can cause permanent loss of bowel and bladder control, sexual function and even paralysis of the legs.

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Fortunately, the condition is rare. It can be caused by a traumatic injury to the spine,  a herniated (slipped) disc, spinal stenosis (arthritic narrowing of the spinal canal), a tumour, an infection/abscess or by an accidental medical cause following spinal surgery, spinal anaesthetic or a lumbar puncture procedure.

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What to look out for?

There is no single symptom that defines cauda equina syndrome and it is easily missed.  Having high clinical suspicion and acting quickly is key.

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Here are some of the symptoms:

• Severe pain affecting both legs

• Saddle paresthesia - numbness in the groin or area of contact if you were sitting on a saddle

• Bladder disturbance - inability to urinate, hesitancy, incontinence, decreased sensation

• Bowel disturbance - incontinence, constipation, loss of anal tone and sensation

• Sexual dysfunction

• Numbness and weakness affecting one or both legs

• Altered walking ability / restricted mobility

• Severe unremitting lower back pain 

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If you are concerned that you may have cauda equina syndrome, then seek urgent medical attention.

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