Cauda Equina

Question 1

What is cauda equina?

Answer 1

A rare but serious condition where the lumbosacral nerve roots that extend beyond the spinal cord are compressed

Question 2

What is the aetiology of cauda equina?

Answer 2

• Most common is central disc prolapse: L4/5, L5/S1
• Tumours
• Infection
• Trauma
• Haematoma

Question 3

How does cauda equina present?

Answer 3

• Lower back pain
• Bilateral sciatica
• Reduced sensation/pins and needles in perianal area
• Decreased anal tone
• Urinary dysfunction: incontinence, reduced awareness (often a late sign)

Question 4

How is cauda equina investigated?

Answer 4

Urgent MRI

Question 5

How is cauda equina managed?

Answer 5

Surgical decompression