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Cauda equina syndrome

A debilitating condition which can cause paralysis and incontinence if not treated urgently

About

Cauda equina syndrome (CES) is damage to the bundle of nerves below the end of the spinal cord known as the cauda equina. Symptoms include lower back pain which radiates down the leg, numbness and loss of bowel or bladder control. It's a rare condition, but does need emergency surgical intervention.

Need to know

  • Symptoms of cauda equina syndrome icon plus

    Cauda equina syndrome symptoms vary according to the degree of nerve compression. For some patients, cauda equina syndrome develops suddenly while other people may experience symptoms slowly. Symptoms of cauda equina syndrome include:


    • neurological symptoms such as weakness, tingling, or numbness in the legs and feet on one side
    • numbness or tingling in the 'saddle region', including the groin, the buttocks and genitals, and thighs
    • bladder or bowel incontinence; trouble passing urine and loss of rectal control
    • sharp or stabbing pain in the legs (down to sciatic nerve pain
    • lower back pain (usually a dull ache and stiffness)
  • Diagnosis icon plus

    An MRI scan is the most effective way to diagnose cauda equina syndrome as it shows soft tissues. If you're displaying symptoms of back pain or sciatica, coupled with bladder, bowel or sexual problems, your consultant will recommend an MRI scan urgently.

    In less severe cases, they'll ask you questions about your medical history and carry out a physical exam to assess strength, reflexes, sensation, stability and range of motion. If you're unable to have an MRI scan, a CT scan or myelogram (where your spinal canal is injected with dye and an X-ray taken) may also be recommended. This helps your consultant locate pressure on the spinal canal.

  • Potential treatment options icon plus

    To prevent permanent damage, emergency treatment is required — usually within a few hours of displaying symptoms. Otherwise it could lead to permanent paralysis and incontinence. Surgical decompression is an effective way to treat the condition.

    The aim of the surgery is to reduce or eliminate pressure on the impacted nerves in order to reduce damage and relieve pain. This is called a lumbar laminectomy. If permanent damage has occurred, symptoms can be relieved through physical therapy and pain relief injections.

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This content is intended for general information only and does not replace the need for personal advice from a qualified health professional.
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