Cauda Equina Syndrome

Causes:

 • Large lumbar degenerative disc herniation (central)

 • Severe lumbar spondylosis

 • Neoplasm in lumbar spine

 • Trauma or epidural hematoma

 • Infection (abscess, etc) in lumbar spine

Signs / Symptoms / Complications:

 • Weakness (flaccid paralysis) in both legs

 • Areflexia (loss of normal leg reflexes)

 • Urinary and fecal retention -> Overflow Incontinence

 • Saddle Anesthesia

 • Sensory disturbance in both legs (numbness, tingling, loss of temperature sensation, etc)

 • Neuropathic pain (shooting, stabbing, lancinating, burning pain radiating down both legs)

Note: Surgical Emergency!

 • Goal is to prevent permanent damage to sacral nerves which can happen quickly (within hours) if not treated!

 • Pain/sensory disturbance in legs does not have to be bilateral.

 • As soon as bladder/bowel dysfunction is suspected, immediate MRI and surgery!



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