Cauda Equina

Question 1

What is cauda equina syndrome?

Answer 1

Clinical syndrome resulting from compression of the cauda equina nerve roots (S3-5).

Question 2

What are the causes of cauda equina syndrome?

Answer 2

1. Direct trauma - lumbar disc herniation, LP, fractures
2. Lumbar spinal stenosis
3. Tumour, abscess, haematoma
4. Inflammatory conditions

Question 3

What is this a presentation of?
Severe back pain, bilateral leg pain, saddle anaesthesia/paraesthesia, painless urinary retention, bladder and bowel dysfunction, weakness of muscles in lower legs, areflexia, flaccid paralysis, sexual dysfunction, absent anal tone.

Answer 3

Cauda equina syndrome

Question 4

How is cauda equina syndrome diagnosed?

Answer 4

1. Absent sensation on neurological exam
2. Reduced sphincter tone on PR
3. MRI

Question 5

What is the management for cauda equina syndrome?

Answer 5

Emergency surgical decompression - discectomy