Cauda Equina Syndrome Anatomy

If you have been diagnosed with Cauda Equina Syndrome, you will want to know more about the condition. Here we take a closer look at the anatomy of the body, explaining where the cauda equina nerves are, what they do and how they can suffer an injury.

What is the cauda equina?

The cauda equina is a bundle of nerves located at the bottom of the spinal cord. ‘Cauda equina’ is Latin and means horse’s tail, so-called because of its appearance.

The spinal cord runs from the brain, through the space in the middle of the spine (called the spinal canal) and down to the lower back. The entire spinal cord is protected by the 33 vertebrae which make up the spinal column. The spinal column is longer than the spinal cord, thereby ensuring the spinal cord is not exposed.

The spinal cord tapers off into the conus medullaris. The conus medullaris then branches into a number of different nerves which together are known as the cauda equina nerves. These contain various nerve roots include lumbar one to five (L1-5) and sacral one to five (S1-5). The nerves roots L4-S4 join on to the sciatic nerve, one of the largest nerves in the body.

What do the cauda equina nerves do?

The cauda equina nerves enable both motor and sensory function in the pelvic organs and lower limbs. More specifically they are responsible for:-

• Sensation in the bladder and urethra
• Sensation in the perineum (the area of skin between the genitalia and anus)
• Internal and external anal sphincter function
• Function of the pelvic organs (bladder, bowel and genitalia)
• Function of the lower limbs, including hips, legs, knees, ankles and feet

How can the cauda equina nerves be injured?

The cauda equina nerves are very sensitive and will quickly become injured should they come under any sort of pressure. Nerve compression can happen in a number of ways, with a slipped lumbar disc being the most common cause. Other causes include a spinal tumour, an infection, an inflammatory disease, a crushing injury sustained in a traumatic accident or a fracture.

Whatever the underlying reason, nerve compression will obstruct the blood supply to the nerves, depriving them of oxygen. If this continues for too long the nerves will start to break down and normal function will be lost. If compression lasts for over 48 hours, the damage will be so severe that the nerve roots actually die, resulting in permanent loss of function.

It is therefore vital that treatment is provided before the nerves are too badly injured. If medical professionals fail to do so, there could be grounds for a compensation claim.

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