Cauda equina syndrome is a spinal cord syndrome in which nerve roots in the lumbar spine are constricted. Common symptoms include back pain, sensory disturbances in the buttocks and thighs and sudden incontinence. Acute cauda equina syndrome is an emergency and must be treated surgically in a clinic as quickly as possible.
Here you will find further information and selected specialists for cauda equina syndrome.
Cauda equina syndrome (ICD code G83.4) is damage to the nerve fibers at the lower end of the spinal cord.
The cauda equina is a collection of nerve roots that run in a tissue sac(dural sac) within the spinal column. The structure begins at the conus medullaris, approximately at the level of the first lumbar vertebra, and extends to the sacrum in adults.
The shape of the nerve roots is reminiscent of a horse's tail, which is why they bear the name cauda equina (Latin for horse's tail). The dural sac, which protects the nerve structure, is filled with cerebrospinal fluid.
Normally, the nerve roots have sufficient space in this dural sac and can change their position depending on their location. In cauda equina syndrome, however, the dural sac is compressed. This increases the pressure inside the tissue sac so that the nerve roots are constricted and, in the worst case, damaged.
Here you can see the location of the cauda equina in the lower spine © Henrie / Fotolia
The main cause of cauda equina syndrome is herniated discs, often in conjunction with a narrow spinal canal(spinal canal stenosis). In this case, parts of the intervertebral disc protrude into the spinal canal and press on the nerve fibers.
Tumors or metastases in the area of the lumbar spine can also cause cauda equina syndrome. Anatomical changes, such as those that occur in embryonic spina bifida, are also considered a risk factor for cauda equina syndrome.
The nerve compression leads to various neurological deficits, such as
Due to their typical localization, these sensory disturbances are also referred to as breeches anaesthesia.
Cauda equina syndrome is also characterized by
Patients with cauda equina syndrome are often no longer able to lift their feet(weak foot lifter).
Further indications of cauda equina syndrome may be
If these symptoms occur, action must be taken quickly! Especially if back or intervertebral disc disease is already known.
If the diagnosis is clear, cauda equina syndrome is a neurosurgical emergency. Rapid treatment of cauda equina syndrome is urgently required. The surgeon performs an operation to decompress the nerves.
If this procedure is not carried out within six hours of the first symptoms appearing, there is a high risk of permanent nerve damage.
The prognosis of cauda syndrome depends on
depends. The patient's age, gender and any underlying illnesses also play a role in the course of the syndrome.
In the case of a complete CES, the chances of a complete and rapid recovery of nerve function are rather low. Many patients retain neurological deficits and continue to suffer from incontinence or paralysis even after the surgical procedure.
Prognostically unfavorable signs include, in particular, weakness of the sphincter muscles with faecal and/or urinary incontinence.
Even if the chances of complete recovery are rather low, cauda equina syndrome should be treated as quickly as possible. As soon as there are initial indications of nerve compression, it is therefore advisable to call an emergency doctor immediately.
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