Cauda equina syndrome

Cauda equina syndrome describes a combination of symptoms and signs which result from a lesion of the nerves in the cauda equina

The cauda equina begins in most people around L1/L2

The most common cause of cauda equina is disc herniation 

Other causes of cauda equina include: 
  • Lumbar spinal stenosis 
  • Epidural abscess 
  • Epidural haematoma 
  • Tumours
  • Trauma 
  • Ankylosing spondylitis
  • Inferior vena cava thrombosis 

Signs and symptoms of cauda equina syndrome include: 
  • Low back pain 
  • Urinary retention or incontinence 
  • Faecal incontinence/constipation 
  • Loss or decrease of lower limb reflexes 
  • Decreased anal tone 
  • Saddle/perianal paraesthesia 
  • Motor/sensory weakness in lower limbs

Investigation is MRI

Management is surgical 
High dose steroids may have a role whilst awaiting surgery 

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