Cauda Equina Syndrome Definition

In this article we explore cauda equina syndrome in detail, explaining what it is, how it is treated and what the prognosis for recovery is.

Definition of cauda equina syndrome

Cauda equina syndrome (CES) is a neurological condition. It happens when the cauda equina nerves are compressed.

The cauda equina nerves are so-called because they resemble a horse’s tail. They are found at the bottom of the spinal cord and serve the lower limbs, pelvic organs and sexual organs.

If the nerves are compressed, they will become damaged and a degree of function will be lost. The level of dysfunction will become progressively worse as the nerves become increasingly damaged.

The cauda equina nerves can become compressed for a number a reasons. The most common cause is a slipped lumbar disc, with spinal tumour, congenital disease, infection and traumatic injuries being other possible causes.

Symptoms of cauda equina syndrome

The damaged caused by compression means that the cauda equina nerves will not be able to work properly. The individual in question will begin to notice reduced neurological function, particularly in relation to the lower limbs, pelvic organs and sexual organs.

More specifically, the symptoms of cauda equina syndrome include:-

• Chronic lower back pain. This may extend to one or both legs, creating a sciatic-like pain;
• Weakness in the lower limbs with poor reflexes;
• Numbness between the legs (in the perineum) and the buttocks;
• Bladder dysfunction, including increased urinary frequency, the inability to fully void, and reduced sensation while urinating;
• Bowel dysfunction, including constipation and faecal incontinence due to the loss of anal tone;
• Sexual dysfunction, including erectile dysfunction and the loss of sensation in the penis, perineum and vagina.

Prognosis for recovery

It is possible to cure cauda equina syndrome, but only if treatment is provided immediately. As long as the nerves are decompressed before too much damage is done, a patient can go on to regain normal function, although this may take a number of years.

However, if the nerves come under sustained pressure, the damage will be extensive. Within a short space of time the root cells will die, after which the injury will be permanent. Treatment provided thereafter will not improve a patient’s condition and he/she will remain symptomatic for the foreseeable future.

If long-lasting complications do occur, questions must be raised as to the level of care provided. If medical professionals failed to diagnose and treat the condition in a timely fashion, there will be a case of medical negligence.

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