Cauda equina syndrome (CES) is when the nerve roots at the base of the spinal cord are compressed. Known as the cauda equina, this bundle of nerves is 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.
A common cause of CES is injury of a spinal disk on the nerve roots. A spinal disk is a semi-soft mass of tissue between the bones of the spine. These bones are known as the vertebrae. The disks act as the spine’s shock absorbers. When a disk spills out into the spinal canal, it can press against the bundle of nerves, causing CES. This syndrome may also be caused by:
Factors that may increase your risk of developing CES include:
Symptoms may include:
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 sphincter function.
Images may be taken of your bodily structures. This can be done with:
Your muscle activity may be measured. This can be done with electromyography.
Talk with your doctor about the best treatment plan for you. Treatment options include the following:
Your doctor may also treat the underlying cause of CES.
The long-term effects of CES can range from mild to severe. Problems may include:
Your follow-up care may involve working with a:
Cauda Equina Syndrome Resource Center
Spinal Cord Resource Center—United Spinal Association
Canadian Spinal Research Organization
Spinal Cord Injury Canada
Cauda equina syndrome. American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=a00362. Updated March 2014. Accessed November 20, 2014.
Cauda equina syndrome. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated August 20, 2014. Accessed November 20, 2014.
Last reviewed November 2014 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.