In this article we explain what cauda equina syndrome is, including how the condition is caused, how it is diagnosed and how it is treated.
What is cauda equina syndrome?
Cauda equina syndrome is a neurological condition. It occurs when the cauda equina nerves at the bottom of the spinal cord are compressed and damaged. Cauda equina compression can happen in a number of ways, including: a traumatic injury, a prolapsed disc, an inflammatory condition, an infectious condition, and lesions on the spine (such as a spinal tumour).
What are the symptoms of cauda equina syndrome?
The symptoms of cauda equina syndrome are:-
- Chronic back pain;
- Sciatica in one or both legs;
- Sensory changes in the saddle or perineal area;
- Urinary and bowel dysfunction – e.g. inability to void without squeezing;
- Sexual dysfunction – e.g. inability to achieve an erection;
- Reduced rectal tone;
- Numbness and weakness in the lower limbs;
- Reduced or loss of reflexes in the lower limbs.
The symptoms of cauda equina syndrome will either appear very suddenly (sudden onset) or over a matter of months (gradual onset). The symptoms will become worse with time.
Diagnosing cauda equina syndrome
The most obvious symptoms of cauda equina syndrome are: bowel, bladder and sexual dysfunction, and sensory changes in the saddle/perineal area. A patient with these symptoms should be suspected of having cauda equina syndrome and undergo further tests to confirm/exclude this diagnosis.
When cauda equina syndrome is suspected, the investigation of choice is an MRI scan. Depending upon the urgency of the clinical situation, the scan needs to be performed on either an emergency or an urgent basis.
Treating cauda equina syndrome
Cauda equina syndrome must be treated according to the underlying cause. For example, if an infection is present, antibiotics must be administered.
In the overwhelming majority of cases, surgical treatment will be required. This will involve either emergency or urgent surgical decompression of the dural sac. The operation of choice is usually a laminectomy followed by a discectomy, but for those surgeons who are experienced in microsurgery a lumbar microdiscectomy is a reasonable alternative.
Outcome of cauda equina syndrome
Cauda equina syndrome can result in permanent neurological complications, including bladder, bowel and sexual dysfunction, weakness in the lower limbs and partial/total paralysis. Normally such complications will affect patients who are not operated on quickly enough.
If treatment is delayed because of medical error – such as a delay in diagnosis – a patient’s complications will be attributed to medical negligence. If you have suffered cauda equina complications because of substandard hospital care, you could be entitled to receive compensation. Contact us today for more information.