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Consultant Spine Surgeon
& Honorary Professor

Cauda Equina Syndrome

Cauda equina syndrome is a relatively rare but serious condition that describes extreme pressure and swelling of the nerves at the end of the spinal cord. It gets its name from Latin,"horse’s tail," because the nerves at the end of the spine visually resemble a horse’s tail as they extend from the spinal cord down the back of each leg.

Cauda equina syndrome is a serious medical emergency that requires testing and possibly urgent surgical intervention. If patients with cauda equina syndrome do not get treatment quickly, adverse results can include permanent paralysis, impaired bladder and/or bowel control, difficulty walking, and/or other neurological and physical problems.

Cauda Equina Syndrome Causes

Cauda equina syndrome is caused by the compression of nerves in the lumbar spine and a narrowing of the spinal canal. This pressure on the spinal nerves can occur from several underlying causes, including:

  • Any spinal condition that may compress the nerves in the lower back most commonly a lumbar herniated disc or lumbar spinal stenosis
  • Infections in the spinal canal, such as a spinal epidural abscess in the spinal canal
  • Spinal tumors that can put pressure on the nerves in the lower spine
  • Injury that penetrates the lower back, such as a gunshot or knife wound
  • Trauma to the lumbar spine, such as a car accident, fall, or surgery.

Cauda Equina Syndrome Symptoms

Typical symptoms of cauda equina syndrome are variable in intensity and onset, and may include one or more of the following:

  • Altered sensation, or severe or progressive weakness or numbness in the lower extremities, the legs and/or feet, possibly making it difficult to walk
  • Loss of sensation or a strange sensation in the "saddle" area (the area of the body that would sit on a saddle: inner thighs/between the legs, buttocks, back of legs, sacral region)
  • Urinary or bowel incontinence, including any dysfunction that causes retention of urine, inability to hold urine in, or loss of rectal control
  • Lower back pain, which may be described as an aching pain in a localized area
  • Sharp stabbing pain in the leg.