Cauda equina is a rare syndrome that can lead to paralysis if left untreated. Most cases of paralysis are due to catastrophic injuries, such as sustained blows to the head or neck, car accidents, or athletic injuries. But cauda equina syndrome is a secondary condition which results from a disease or infection of the cauda equina spinal nerves.

The Cauda Equina: A Brief Tutorial

Cauda equina is Latin for “horse's tail,” and the term refers to a bundle of nerve fibers and nerve roots located at the base of the spine. The cauda equina extend from the second lumbar nerve, through the fifth sacral nerve, and into the coccygeal nerve.

All nerves associated with the cauda equina originate in the spinal cord's conus medullaris. The cauda equina play a key role in lower body movement and sensation, including walking, elimination, bladder function, sexual function, and most other movements of the legs and lower body.

What is Cauda Equina Syndrome?

Cauda equina syndrome is not a disease unto itself, but rather a symptom of another condition. Cauda equina syndrome occurs when something compresses the cauda equina nerves or nerve roots. The result is typically an immediate decline in functioning, accompanied by numbness and potentially even paralysis.

Cauda equina syndrome is always a medical emergency. It is akin to a fall on the back or neck, due to its ability to lead to permanent paralysis if left untreated.

The symptoms of cauda equina syndrome vary in severity, but the most common symptoms include:

  • Sudden severe sexual dysfunction, such as the inability to ejaculate or experience sexual pleasure.
  • Numbness, pain, or weakness in one or both legs that is serious enough to inhibit your movement, cause stumbling, or make it difficult to rise from a sitting position.
  • Changes in sensations in your legs, buttocks, or thighs that get steadily worse. You may experience numbness, tingling, or other unusual sensations.
  • Difficulties with bowel or bladder function that aren't well-explained by another condition.

What Causes Cauda Equina Syndrome?

A number of conditions predispose you to cauda equina syndrome, so knowing whether you're at risk can help you avoid suffering from this dangerous and life-altering syndrome. Any serious spinal cord injury or back health problem increases your risk, but the following risk factors are especially problematic:

  • Spinal stenosis due to narrowing of the spinal canal.
  • A severely ruptured disk in the lumbar region; this is the most common factor in cauda equina syndrome cases.
  • A traumatic spinal injury due to a gun shot, stabbing, auto accident, fall, or other catastrophe.
  • A spinal lesion or tumor.
  • A spinal infection.
  • Spinal hemorrhages or fractures.
  • Birth defects that result in abnormal blood vessel connections, such as arteriovenous malformation.

If you suffer from pain in this region, experience numbness or tingling, or experience more than low-level chronic back pain, consult your doctor to ensure you're not suffering from a disease that puts you at risk of cauda equina syndrome.

Treatment for Cauda Equina Syndrome

There is no single treatment for cauda equina syndrome, since cauda equina is not a disorder unto itself, but the product of another medical condition. Instead, your doctor may perform blood tests, spinal imaging, and a differential diagnosis to determine the source of your cauda equina syndrome. Depending upon your test results, treatment may include:

  • Spinal surgery, which focuses on decompressing the cauda equina nerves
  • Antibiotics, usually in intravenous form if the infection is severe enough to affect your spine
  • Physical therapy, including regular exercise
  • Lifestyle changes designed to reduce your future risk

If your cauda equina syndrome leads to paralysis, you may have a lengthy hospital stay, followed by intensive physical therapy, the use of assistive devices, and ongoing evaluation of your treatment options.

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