What Is Cauda Equina Syndrome (CES)

What is Cauda Equina Syndrome (CES)?

Cauda equina syndrome is an uncommon spinal condition that develops from a spinal abnormality severely compressing nerve roots. The condition affects the cauda equina, which are a bundle of nerve roots located at the lower end of the lumbar spine section.

Cauda equina syndrome s a neurological (nerve) condition. It may be regarded as a form of spinal cord injury (SCI).

As we know, within your spine, there is a spinal cord which extends from the brain down through a canal inside the vertebral column. At each level of the spine, there are nerves branching off from your spinal cord. These are called nerve roots. They are responsible for sending signals to and from the muscles and other structures throughout the body.

The area which we need to concentrate on is the area of the spine which is approximately just above the waist. This area of the spine is where the spinal cord finishes. Below this is the group of nerves which are called the Cauda Equina. The nerves of the Cauda Equina are responsible for the supply of nerves to the bladder, bowels, lower limbs and also supply sensation to the skin around the bottom and back passage.

Cauda Equina Syndrome is the signs and symptoms when the nerves of the Cauda Equina are compressed.

Ways to contract Cauda Equina Syndrome include:
- Ruptured lumbar discs
- Spinal Stenosis
- Spinal Lesion or Tumor
- Spinal Infection or Inflammation
- Trauma
- Spinal Injections
- Birth Defects
- Surgical Errors

How does Cauda Equina Syndrome (CES) affect people?

Cauda Equina Syndrome is a devastating condition which can damage many aspects of life.

Some sufferers will have diffculty in continuing to work, or continue in hobbies/pastimes that they did before Cauda Equina Syndrome. Many reasons contribute to this..pain being a primary factor, reduced mobility due to loss and weakness of muscle power and  continence problems. Many individuals have added stress and anxiety at learning to live with such life changing and devastating condition.

Loss of bladder and bowel control is highly likely with Cauda Equina Syndrome sufferers and with this comes additional problems. Difficulties managing an effective bowel programme, learning to self catheter...deal with embaressing leaking and repeated urinary tract infections (UTI).

Loss of sexual dysfunction can have a devastating effect to the sufferer and his/her partner and this may lead to relationship difficulties and depression.

Severe nerve-type (neurogenic) pain presents itself in several ways and not all medication is effective some require strong painkillers and even the painkillers can cause another problem with the side effects.
Neurologenic pain can feel like 'burning' to the skin  also  electric shock type pain or pain from non-painful stimulus such as light touch where the skin is over sensitive.

Nerve pain tends to be and feel  worse at night, which can interfere with sleep and then sleep deprivation becomes an additional problem. Even though parts of the skin may be numb due to the nerve damage caused by Cauda Equina Syndrome, the nerve pain can still be felt there.

Sensory loss may range from pins and needles to complete numbness, and may affect the bladder, bowel and genitalia (and therefore exacerbate the problems with these organs).

Weakness is usually in the legs and this can cause problems with upright mobility, many sufferers are part or full time wheelchair users or crutch users. "Foot drop" where the foot drags and causes trips and falls. 

These are the symptoms of Cauda Equina Syndrome

- Altered sensation of the lower limbs and saddle area
- Severe or progressive weakness or numbness in the lower extremities, the legs and/or feet making it difficult to walk
- Lower Back Pain
- Pain radiating in one leg and then into both legs
- Urinary or bowel incontinence, including any dysfunction that causes retention of urine, inability to hold urine in
- Loss of rectal control
- Sharp stabbing pain in the leg
- Sexual dysfunction

Sudden onset:Symptoms of the sudden onset of cauda equina syndrome are typically marked by bladder and/or bowel incontinence or dysfunction and/or progressive weakness in the legs and/or feet.

Gradual onset: Symptoms of the gradual onset of cauda equina syndrome typically include recurring back pain in combination with muscle weakness and numbness and bladder and/or bowel incontinence or dysfunction.

Once Cauda Equina Syndrome is suspected the doctor/specialist normally carries out a rectal examination. The lack of anal tone is part of the  assessment when Cauda Equina Syndrome is suspected.

Treatment of Cauda Equina Syndrome involves decompression surgery as an emergency which should take place ideally within 48 hours after the onset of symptoms. This provides opportunity for the best possible outcome.