Cauda Equina Syndrome
The cauda equina is the leash of nerves in the lumbar spine canal below L1-2 where the spinal cord terminates. The leash of nerves has been likened to hair in the tail of a horse and the term cauda equina is Latin for horse’s tail.
This rare syndrome refers to the situation where there is acute compression of the cauda equina nerves in the lumbar canal. The compression is often due to a massive disc prolapse in younger patients, but can also be due to more sinister problems like cancer or haemorrhage.
Regardless of the cause, the cardinal symptoms are severe back and often leg pain in both legs (sciatica) and associated weakness and numbness, with loss of bowel &/or urinary continence and numbness in the perineal area (bottom and vagina or scrotum).
Cauda Equina syndrome is regarded as a surgical emergency and requires urgent investigation with preferably MRI so that a cause can be established and emergency surgical decompression can be performed.
If decompression is achieved in a timely fashion then return of function can be expected but if there is significant delay in performing the decompression then there can be permanent nerve damage leading to bowel and bladder dysfunction, and or leg weakness and numbness. Sexual dysfunction is also a common long-term problem.