Cauda Equina Syndrome
Lower back pain is known to affect millions of people every year, and in most cases, it also improves without any surgery. However, in some cases, lower back pain can also be a symptom of a serious condition which may often be misdiagnosed. This condition is cauda equina syndrome, which occurs when the nerve roots of the cauda equina are compressed and disrupt motor and sensory function to the lower extremities and bladder.
Patients suffering from this syndrome generally require hospital admittance as a medical emergency. This condition can lead to incontinence and in some cases, even permanent paralysis.
Symptoms
The symptoms of cauda equina syndrome can mimic symptoms of other conditions. It is noteworthy that the symptoms can vary in intensity and can evolve over time.
Patients having back pain may be aware of the following symptoms which might indicate cauda equina syndrome:
- Severe low back pain
- Motor weakness, sensory loss, or pain in one, or more commonly both the legs
- A loss of reflexes
- Recent onset of bowel incontinence
- Recent onset of bladder dysfunction
- Recent onset of sexual dysfunction
- Sensory abnormalities in the bladder or the rectum
- Saddle anesthesia
Causes
Cauda equina syndrome is generally known to occur more often in adults than in children. In children, it occurs among those who have a spinal birth defect or have suffered a spinal injury.
Usually, this condition is caused by the following causes:
- A severe ruptured disk in the lumbar area (the most common cause)
- Narrowing of the spinal canal (stenosis)
- A spinal lesion or malignant tumor
- A birth defect such as an abnormal connection between blood vessels
- A spinal infection, inflammation, hemorrhage, or fracture
- A complication from a severe lumbar spine injury which can be a fall, a car crash, a gunshot, or a stabbing
Diagnosis
A doctor can diagnose cauda equina syndrome using any of the following methods:
Medical history
Here you will need to answer questions regarding your health, symptoms, and activity.
Physical exam
This will help to assess your strength, sensation, stability, reflexes, motion, and alignment. A blood test maybe required as well.
Magnetic Resonance Imaging
In this method, magnetic fields and computers are used to produce three-dimensional images of the spine.
Myelogram
In this method, a contrast material is injected into the body, after which an X-ray is taken. This can help to pinpoint pressure on the spinal cord or the nerves.
Sometimes, computed tomography or a CT scan might be used as well.
Treatment
Patients suffering from cauda equina syndrome generally require prompt treatment to relieve pressure on the nerves. Surgery needs to be done quickly to prevent any permanent damage, such as paralysis of the legs, loss of bladder and bowel control, sexual function, or any such problems.
Depending on the cause of the condition, high doses of corticosteroids might also be required as it can help in reducing swelling. If you are diagnosed with an infection, antibiotics will be needed. If a tumor is responsible, then radiation therapy or chemotherapy might be required after the surgery.
In some cases, you may not retrieve full function, even after treatment. This is going to depend on how much damage has occurred. However, if the surgery is a success, you might continue to recover bladder and bowel function over a few years.
It is important to note that if permanent damage has occurred, then surgery is not going to always repair it. This condition is chronic. Therefore you will need to learn ways to adapt to changes in the functioning of your body. Both physical and emotional support is necessary.