Cauda Equina - week 21

Question 1

What is cauda equina syndrome?

Answer 1

Surgical emergency - compression of cauda equina

Question 2

Epidemiology?

Answer 2

Does not vary in populations

Question 3

Pathophys of cauda equina syndrome?

Answer 3

compression of nerve roots terminating at L2/L3

Herniated disc (most common cause)
Tumours, particularly metastasis
Spondylolisthesis
Abscess
Trauma

Question 4

Red flag presentation of cauda equina?

Answer 4

Saddle anaesthesia
Loss of sensation in bladder and rectum
Reduced erections
Urinary retention or incontinence
Faecal incontinence
Bilateral sciatica
Bilateral or severe motor weakness in the leg
Reduced anal tone

Question 5

Management of cauda equina sydrome?

Answer 5

Emergency MRI
Emergency surgery

Question 6

Prognosis of CES?

Answer 6

Sooner surgery - better outcomes
still chance of bladder, bowel, sexual dysfunction, leg weakness etc