Causes of Cauda Equina Syndrome
Although the Cauda Equina is protected by the backbone it a still remains vulnerable to injury and trauma. There are two groups of causes.
Congenital - from birth:- Spina Bifida
- Tumours of the cauda equina
- Injury and trauma
- Following medical procedure
- Disc Herniation - slipped or prolapsed disc
- Tumour of the cauda equina
- Vescular problems of the CE
- Infections such as cytomegalorvirus
Symptoms of Cauda Equina Syndrome
Most cases are sudden, however some progress slowly with none or little pain.
- Low back pain
- Dysfunction of pelvic organs namely:
- Bowel
- Bladder
- Sexual organs
- Other symptoms include:
- Walking difficulty
- Severe unexplained pain
Treatment of Cauda Equina Syndrome
Patients should be referred immediately for a neurosurgical consultation. Urgent surgical spinal decompression is required for most patients to prevent permanent damage.
Immobilise spine if cauda equina syndrome is due to injury. Surgery required to remove blood, bone fragments, tumour, herniated disc or abnormal bone growth.
- Lesion debulking is required for space occupying lesions, e.g. tumours, abscess.
- If surgery cannot be performed, radiotherapy may relieve cord compression caused by malignant disease.
- Other treatment may be useful in certain patients, depending on the underlying cause of the cauda equina syndrome:
- Anti-inflammatory drugs, can be effective in patients with inflammatory causes, e.g. ankylosing spondylitis.
- Infection causes should be treated with appropriate antibiotics.
- Patients with spinal neoplasms should be evaluated for chemotherapy and radiation therapy.
- Postoperative care includes addressing lifestyle issues, e.g. obesity, and also physiotherapy and occupational therapy, depending on residual lower limb disfunction.