Cauda Equina

Question 1

What is it

Answer 1

A rare but serious condition that occurs when the bundle of nerves at the lower end of the spinal cord is compressed.

Question 2

Features

Answer 2

Severe lower back pain - sudden and intense
Saddle anaesthesia
Bladder or bowel dysfunction
Leg weakness or paralysis - one or both
Sexual dysfunction
Reflex changes - decreased
Sciatica like symptoms - pain radiating down the leg

Question 3

Epidemiology

Answer 3

Rare - 1in 33,000 to 100,000 annually
Common causes - herniated disc, trauma, tumours, spinal stenosis to infections
Affects both genders

Question 4

Age

Answer 4

30 to 50 - due to disc herniation or spinal stenosis
Older adults - spinal stenosis
Younger - trauma

Question 5

Risk/ Cause

Answer 5

Herniated disc
Spinal stenosis
Trauma - fractures, dislocations
Tumours
Infection - epidural abscess
Post surgery - scar tissue compressing on nerves

Question 6

Presentation

Answer 6

Acute onset of severe lower back pain
Bladder and bowel dysfunction
Saddle anaesthesia
Leg weakness or paralysis
Sexual dysfunction
Reduced reflexes

Question 7

Prognosis

Answer 7

Time sensitive - outcome depends how quickly the condition is diagnosed and treated. Surgery within 48 hours to decompress the spinal nerves

Partial or full recovery

Long term complications