Cauda equina syndrome (CES) is a serious neurologic condition in which damage to the cauda equina causes loss of function of the lumbar plexus (nerve roots) of the spinal canal below the termination (conus medullaris) of the spinal cord. CES is a lower motor neuron lesion.
The nerves at the end of the spine can be likened in appearance to a horses tail, hence the term ‘Cauda Equina’ which is latin for horses tail. The Cauda Equina contains pairs of nerve roots which extend from the spinal cord into the back of each leg. The Cauda Equina nerves affect the bowel, bladder, pelvis and lower limbs. Cauda Equina Syndrome is a surgical emergency. Nerves located in the lumbar region of the spinal canal are severely compressed which can lead to bowel, bladder and sexual dysfunction, pain and mobility difficulties.
Due to the devastating consequences the impact of prolonged compression can have, a patient presenting with symptoms of Cauda Equina Syndrome should be referred for an urgent MRI scan to confirm the diagnosis. Decompression surgery should be performed within 48 hours of presenting symptoms. If surgery is delayed for more than 48 hours this can lead to a permanent disability such as incontinence or paralysis.