Cauda Equina Syndrome Info

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Cauda Equina Syndrome is a devastating medical condition which medical personnel are not always familiar with.  It usually requires emergency surgery in order to avoid permanent damage to the nerves which control feeling below your waist.  Nerves regrow very slowly so the healing process takes years.  Even with timely emergency surgery, you will most likely never recover completely.  Most victims of Cauda Equina Syndrome find their lives altered forever.

It robs you of your balance & ability to walk, control of your bladder & bowels, provides you with mild to severe nerve pain, and destroys your sexual functionality.  Many live out their days with pain medicine, diapers & catheters, wheelchairs or walkers.  Some are permanently, totally disabled.  Most are permanently, partially disabled.

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If you have lower back pain and these symptoms, DEMAND to be evaluated for Cauda Equina Syndrome.

 

Below is patient information from the American Association of Neurological Surgeons.  You can link to the whole article here -  Cauda Equina Syndrome Information

 

 

Cauda Equina Syndrome

November, 2005

Low back pain affects millions of people every year, and in most cases, it improves without surgery. But severe back pain can be a symptom of a serious condition that is not well known and is often misdiagnosed. Cauda equina syndrome (CES) occurs when the nerve roots of the cauda equina are compressed and disrupt motor and sensory function to the lower extremities and bladder. Patients with this syndrome are often admitted to the hospital as a medical emergency. CES can lead to incontinence and even permanent paralysis.

The collection of nerves at the end of the spinal cord is known as the cauda equina, due to its resemblance to a horse's tail. The spinal cord ends at the upper portion of the lumbar (lower back) spine. The individual nerve roots at the end of the spinal cord that provide motor and sensory function to the legs and the bladder continue along in the spinal canal. The cauda equina is the continuation of these nerve roots in the lumbar region. These nerves send and receive messages to and from the lower limbs and pelvic organs.

Causes

CES most commonly results from a massive herniated disc in the lumbar region. A single excessive strain or injury may cause a herniated disc. However, disc material degenerates naturally as you age, and the ligaments that hold it in place begin to weaken. As this degeneration progresses, a relatively minor strain or twisting movement can cause a disc to rupture.

Symptoms and Diagnosis

Patients with back pain should be aware of the following "red flag" symptoms that may indicate CES:

  • Severe low back pain
  • Motor weakness, sensory loss, or pain in one, or more commonly both legs
  • Saddle anesthesia (unable to feel anything in the body areas that sit on a saddle)
  • Recent onset of bladder dysfunction (such as urinary retention or incontinence)
  • Recent onset of bowel incontinence
  • Sensory abnormalities in the bladder or rectum
  • Recent onset of sexual dysfunction
  • A loss of reflexes in the extremities

Treatment

Once the diagnosis of CES is made, and the etiology established, urgent surgery is usually the treatment of choice. The goal is to reverse the symptoms of neural dysfunction. Left untreated, CES can result in permanent paralysis and incontinence.

Those experiencing any of the red flag symptoms should consult a neurosurgeon as soon as possible. Prompt surgery is the best treatment for patients with CES. Treating patients within 48 hours after the onset of the syndrome provides a significant advantage in improving sensory and motor deficits as well as urinary and rectal function. But even patients who undergo surgery after the 48-hour ideal timeframe may experience considerable improvement.

Coping with CES

CES can affect people both physically and emotionally, in particular if it is chronic. People with CES may no longer be able to work, either because of severe pain, socially unacceptable incontinence problems, motor weakness and sensory loss, or a combination of these problems.

Loss of bladder and bowel control can be extremely distressing and have a highly negative impact on social life, work and relationships. Patients with CES may develop frequent urinary infections. Sexual dysfunction can be devastating to the patient and his/her partner and may lead to relationship difficulties and depression.

Severe nerve-type (neurogenic) pain may require prescription pain medication with side effects that may cause further problems. If the pain is chronic, it may become "centralized" and radiate to other areas of the body. Neurogenic pain tends to be worse at night and may interfere with sleep. This type of pain tends to produce a burning feeling that can become constant and unbearable. Sensory loss may range from pins and needles to complete numbness, and may affect the bladder, bowel and genital areas. Weakness is usually in the legs and may contribute to problems walking.

It is essential that people with CES receive emotional support from a network of friends and family members, if possible. It is important to work closely with your physician on medication and pain management. There are several medications prescribed to address pain, bladder and bowel problems. In addition, some patients find that physical therapy and psychological counseling help them cope with CES.

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