Partial Cauda Equina Syndrome

Cauda equina syndrome is a serious neurological condition that progresses from the partial stage to the complete stage within a matter of hours.

What is cauda equina syndrome?

Cauda equina syndrome is when the bundle of nerves at the bottom of the spine becomes compressed. These nerves are called the ‘cauda equina’ because they resemble a horse’s tail. The nerves can become compressed in a number of ways, with a slipped disc being one of the most common causes.

When pressure is placed upon the cauda equina, the blood supply to the nerves will be disrupted. The blood carries the oxygen to the nerves, meaning they will soon become starved of oxygen. In medical terms this is known as ischaemia. When the nerves become ischaemic, they will quickly become damaged, resulting in a loss of function.

When nerve compression leads to the loss of function, the individual in question will soon develop physical problems. These will include back pain, leg pain, bladder dysfunction, numbness in the perineum and sexual dysfunction. When these symptoms appear, a person is said to have cauda equina syndrome.

What is partial cauda equina syndrome?

While it is in the initial stages, the condition is referred to as ‘partial cauda equina syndrome’ or ‘incomplete cauda equina syndrome’. During this time the patient will display the characteristic symptoms of spinal nerve compression, as described above. These include back pain which extends to the leg and bottom, bladder dysfunction, numbness in the perineum and sexual dysfunction.

The defining feature of partial or incomplete cauda equina syndrome is that a patient still has some degree of bladder control. This means he or she can still void of their own accord, although this may be difficult to do so. It will usually be necessary to strain to empty the bladder and there will also be increased frequency.

What is complete cauda equina syndrome?

If the pressure upon the nerves is not relieved, the nerves will become so injured because of the disrupted blood supply that they actually die. Once this happens a patient will have painless urinary retention, meaning he or she will have no control over their bladder whatsoever. There will be no sensation in the bladder, so a patient will not know whether he/she needs to go to the toilet. This often leads to overflow incontinence, whereby the bladder is so full the patient wets himself.

If a patient’s condition is allowed to progress from the partial to the complete stage, the damage will be irreparable. Surgery must therefore be provided early on if these devastating complications are to be avoided.

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