Week 3 - Cauda Equina Syndrome

Question 1

what is cauda equina syndrome?

Answer 1

where a large central disc prolapse compresses all the nerve roots of the cauda equina`

Question 2

what are the main nerve roots affected in cauda equina syndrome?

Answer 2

S4 and S5 but others also contribute

Question 3

what are the potential long term effects of cauda equina syndrome?

Answer 3

permanent nerve damage to S4 and S5 which control urination and defaecation
can ultimately require colonostomy and urinary diversion and urgent discectomy

Question 4

what is the treatment for cauda equina syndrome?

Answer 4

surgical emergency - urgent discectomy

Question 5

is cauda equina syndrome dangerous?

Answer 5

yes

one of the red flags of the spine and suggests serious underlying pathology

Question 6

what are the symptoms of cauda equina syndrome?

Answer 6

bilateral leg pain
paraesthesiae or numbness
“saddle anaesthesia” - numbness around sitting area
altered urinary function (retention or incontinence)
faecal incontinence and constipation can occur

Question 7

when should cauda equina be considered seriously?

Answer 7

any patient with bilateral leg symptoms/signs with any suggestion of altered bladder or bowel function

Question 8

how is cauda equina investigated?

Answer 8

PR exam

urgent MRI