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Cauda Equina Syndrome

Compression of nerve roots at the end of the lumbar spinal cord — a surgical emergency.

Written by: Saygı Hospital Health Guide Editorial Board
Published:

This content is for general information; please consult your physician for diagnosis and treatment.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Ortopedi ve Travmatoloji department. Book Appointment →

What is Cauda Equina Syndrome?

Cauda equina syndrome (CES) is a serious neurological condition occurring as a result of compression of the bundle of nerve roots, resembling a 'horse's tail,' that extends downward from the L1 level after the spinal cord ends. It can lead to bladder, bowel, sexual dysfunction, and lower limb paralysis.

The most common cause is a large lumbar disc herniation (L4-L5, L5-S1), but spinal stenosis, tumor, epidural abscess, hematoma, fracture, and trauma can also cause it. If diagnosis is delayed, the risk of permanent neurological damage is high.

CES has two forms: complete (CES-complete) — urinary retention and overflow incontinence; and early/incomplete (CES-incomplete) — urge to void with difficulty. Both forms require surgical decompression within 48 hours.

Symptoms

Severe low back pain and bilateral sciatica
Saddle area (perianal) numbness
Urinary retention or incontinence
Loss of bowel control
Sexual dysfunction
Lower extremity weakness

Risk Factors

Large central disc herniation
Advanced spinal stenosis
Spinal tumors (primary or metastatic)
Spinal epidural abscess
Spinal anesthesia complications
Lumbar spine trauma

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • If saddle area numbness is present — EMERGENCY
  • Newly developed urinary retention — EMERGENCY
  • Loss of bowel control — EMERGENCY
  • Bilateral leg weakness — EMERGENCY
  • Suspected cauda equina is always 112/emergency

Treatment Methods

01
Diagnosis with urgent MRI
02
Urgent surgical decompression (less than 48 hours golden window)
03
Wide laminectomy
04
Discectomy (if disc herniation is present)
05
Decompression and stabilization in malignancy
06
Abscess drainage and antibiotic therapy
07
Postoperative neurological rehabilitation
08
Long-term urinary-fecal incontinence management

Which Department to Visit?

You can visit our Ortopedi ve Travmatoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

Learn About Ortopedi ve Travmatoloji Department

Let us help you

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.