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Cauda Equina Syndrome

What is Cauda Equina Syndrome?

This is a ‘Spinal Emergency’.

As we know, within your spine, there is a spinal cord which extends from the brain down through a canal inside the vertebral column.

At each level of the spine, there are nerves branching off from your spinal cord. These are called nerve roots. They are responsible for sending signals to and from the muscles and other structures throughout the body.

The area which we need to concentrate on is the area of the spine which is approximately just above the waist. This area of the spine is where the spinal cord finishes. Below this is the group of nerves which are called the Cauda Equina.

The nerves of the Cauda Equina are responsible for the supply of nerves to the bladder, bowels, lower limbs and also supply sensation to the skin around the bottom and back passage.

Cauda Equina Syndrome is the signs and symptoms when the nerves of the Cauda Equina are compressed.

This syndrome has a complex spectrum of signs and symptoms. If your doctor has suspicions of CES, then in some causes it can be confirmed with a MRI scan.

What are the causes of CES?

  • Whilst the Cauda Equina are protected by the vertebrae (the back bone). It is still vulnerable to damage.
  • Tumours of the Cauda Equina
  • Spinal Injury Fracture / trauma
  • Secondary to Medical Procedure
  • Intra-vertebral Disc Herniated (Slipped or Prolapsed Disc)
  • Vascular Problems of Cauda Equina
  • Infections of the Cauda Equina

Red Flag Signs & Symptoms

Red Flag Signs and Symptoms: Patients should be aware of the following “red flag” symptoms that may indicate CES:

  • Saddle Anaesthesia

    • Loss of feeling between the legs
    • Numbness in or around the back passage and / or genitals
    • Inability to feel the toilet paper when wiping
  • Bladder Disturbance

    • Inability to urinate
    • Difficulty initiating urination
    • Loss of sensation when you pass urine
    • Inability to stop or control urination
    • Loss of the full bladder sensation
  • Bowel Disturbance

    • Inability to stop a bowel movement
    • Constipation
    • Loss of sensation when passing a bowel motion
  • Sexual Problems

    • Inability to achieve an erection or ejaculate
    • Loss of sensation during intercourse
  • Nerve Root Pain

    • It is quite common to have a combination of back pain, leg pain, leg numbness or weakness. These symptoms however are common in people who have a history of back problems but do not have Cauda Equina Syndrome.
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