L7: Cauda Equina Syndrome Flashcards
Anatomy of Cauda Equina
Etiology of Cauda Equina Syndrome
Etiology of Cauda Equina Syndrome
- degenerative
Spondylosis and/or lumbar disc prolapse.
Etiology of Cauda Equina Syndrome
- Neoplastic
CP of Cauda Equina Syndrome
CP of Cauda Equina Syndrome
- Side?
Unilateral or Bilateral Asymmetrical
CP of Cauda Equina Syndrome
- Sequence of symptoms
Painful Onset, pain precedes motor or autonomic symptoms
CP of Cauda Equina Syndrome
- Pain
CP of Cauda Equina Syndrome
- Sphincter
CP of Cauda Equina Syndrome
- Radicular Motor Symptoms
CP of Cauda Equina Syndrome
- Radicular Sensory Symptoms
CP of Cauda Equina Syndrome
- Stretch Signs
Lassegue (straight leg raising test), Kernig’s sign,
CP of Cauda Equina Syndrome
- Back
A. Obliteration of lumbar lordosis.
B. Scoliosis.
C. Pain - Tenderness.
D. Paravertebral muscle spasm.
INVx for Cauda Equina Syndrome
- Plain X-ray
- CT Lumbosacral
- MRI Lumbosacral
INVx for Cauda Equina Syndrome
- Plain X-Ray
- Narrow of Intervertebral disc space & intervertebral foramina.
- Subluxation of vertebrae
- Osteophytes
- Loss of lumbar lordosis
- Calcification of ligaments
INVx for Cauda Equina Syndrome
- CT Lumbosacral
Bony Lesion
INVx for Cauda Equina Syndrome
- MRI Lumbosacral
Soft tissue & Postoperative adhesions
TTT of Cauda Equina Syndrome
- Medical
- Surgery
TTT of Cauda Equina Syndrome
- Surgery
TTT of Cauda Equina Syndrome
- medical
- Complete bed rest
- Analgesics.
Site of Conus Medullaris Syndrome
Conus = S3,4,5 segments
Symptoms of Conus Medullaris Syndrome
CP of Conus Medullaris Syndrome
- Sphincter
- Early severe urinary incontinence (autonomous bladder)
- Early fecal incontinence
CP of Conus Medullaris Syndrome
- Sensation
Saddle shaped area hypothesia of dissociated type.
CP of Conus Medullaris Syndrome
- Motor
No Motor or Sensory signs in both L.L
Site of Epiconus Medullaris Syndrome
Epiconus = L4,5 S1,2 segments
CP of Epiconus Medullaris Syndrome
CP of Epiconus Medullaris Syndrome
- Motor
Weakness of
* Plantar & Dorsi flexor of ankle,
* Flexor of knee,
* Extens. of hip
CP of Epiconus Medullaris Syndrome
- Reflexes
Ankle reflex: Lost with preserved knee reflex
CP of Epiconus Medullaris Syndrome
- sensory
Sensory: Loss L4 → S2 (dissociated)
CP of Epiconus Medullaris Syndrome
- Sphincter
Sphincter (precipitancy)