Share this page

Health Library

Cauda Equina Syndrome(CES; Compression of Spinal Nerve Roots; Syndrome, Cauda Equina; Spinal Nerve Roots, Compression)

Pronounced: COW-da Ee-KWI-nah

Definition

Cauda equina syndrome (CES) is compression of the nerve roots at the base of the spinal cord. The nerve roots (known as the cauda equina) are responsible for the sensation and function of the bladder, bowel, sexual organs, and legs. CES is a medical emergency. If treatment is not started to relieve pressure on the nerves, function below the waist may be lost.

Cauda Equina

si1925_105433_1.jpg

Copyright © Nucleus Medical Media, Inc.

Causes

A common cause of CES is injury of a spinal disc on the nerve roots. A spinal disc is a semi-soft mass of tissue between the bones of the spine. These bones are known as the vertebrae. The discs act as the spine’s shock absorbers. When a disc spills out into the spinal canal, it can press against the bundle of nerves, causing CES. This syndrome may also be caused by:

  • Accident that crushes the spine, such as a car accident or fall
  • Penetrating injury, such as a knife or gunshot wound
  • Arthritis, such as ankylosing spondylitis
  • Complications from spinal anesthesia
  • Mass lesion, such as a blood clot
  • Complications from cancer
  • Side effect of certain medications
Risk Factors

Factors that may increase your risk of CES include:

  • History of back problems, such as spinal stenosis
  • Degenerative disc disease
  • Birth defects, such as a narrow spinal canal or spina bifida
  • Hemorrhages affecting the spinal cord
  • Arteriovenous malformation
  • Spinal surgery or spinal anesthesia
  • Lesion or tumor affecting the spinal bones, spinal nerve roots, or cerebrospinal fluid (CSF)
  • Infection affecting the spine
  • Manipulation of the lower back—rarely
Symptoms

CES may cause:

  • Severe low back pain
  • Numbness or tingling in the crotch area known as saddle anesthesia/paresthesia
  • Inability to urinate, or to hold urine or feces
  • Inability to walk or dragging of foot
  • Weakness, loss of sensation, or pain in one or both legs
  • Sexual dysfunction—erectile dysfunction in men
Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done. A neurological exam, which includes testing reflexes, vision, mental status, and strength, may also be done. A rectal exam may be done to assess anal sphincter function.

Imaging tests evaluate the spine and nearby structures. These may include:

Your muscle activity may be measured. This can be done with electromyography (EMG).

Treatment

Talk with your doctor about the best treatment plan for you. Treatment options include the following:

  • Surgery may include:
    • Laminectomy—to remove a portion of a vertebra, called the lamina
    • Discectomy—to remove part of an intervertebral disc that is putting pressure on the spinal cord or nerve root
  • Radiation therapy—If CES is due to cancer, radiation therapy may be an option.

Your doctor may also treat the underlying cause of CES.

Follow-up Care

The long-term effects of CES can range from mild to severe. Problems may include:

  • Difficulty walking
  • Problems with bladder and bowels
  • Sexual dysfunction
  • Paralysis

Your follow-up care may involve working with a:

  • Physical therapist
  • Occupational therapist
  • Neurologist—doctor who specializes in the nervous system
  • Incontinence specialist—if you have lost bladder control
Medication

Your doctor may prescribe medication for:

  • Pain
  • Bladder and bowel difficulties
Prevention

There are no current guidelines to prevent CES.

RESOURCES:

Cauda Equina Syndrome Resource Center
http://www.caudaequina.org

United Spinal Association
http://www.spinalcord.org

CANADIAN RESOURCES:

Canadian Spinal Research Organization
http://www.csro.com

Spinal Cord Injury Canada
http://sci-can.ca

References:

Cauda equina syndrome. American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00362. Updated March 2014. Accessed November 20, 2014.

Cauda equina syndrome. EBSCO DynaMed Plus website. Available at: http://www.dynamed.com/topics/dmp~AN~T115961/Cauda-equina-syndrome. Updated March 2, 2016. Accessed September 29, 2016.



Last reviewed November 2015 by Rimas Lukas, MD

Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.

Baptist Flame

Baptist Health Systems

1-800-948-6262

Find A Doctor

Services

Locations

Baptist Medical Clinic

Patients & Visitors

Learn

Contact Us

Physician Tools

Careers at Baptist

Employee Links

Online Services

At Baptist Health Systems

At Baptist Medical Center

close ×