Cauda Equina Syndrome (lumbar spine)

Question 1

why does this occur

Answer 1

a very large central disc prolapse can compress all the nerve roots of the cauda equina

Question 2

why is this a surgical emergency

Answer 2

affected nerve roots include the sacral nerve roots (S4 and 5) which controls defaecation and urination

Question 3

what can prolonged compression cause

Answer 3

permanent nerve damage requiring colostomy and urinary diversion

Question 4

what can prevent catastrophes

Answer 4

urgent discectomy

Question 5

what are signs and symptoms of cauda equina considered as

Answer 5

red flags that signal serious pathology needing urgent management

Question 6

what do patients usually present with

Answer 6

• bilateral leg pain, paraesthesiae or numbness
• complain of saddle anaesthesia (numbness around sitting area and perineum)
• altered urinary function (usually urinary retention but can be incontinence)
• faecal incontinence and constipation can also occur

Question 7

any patient with bilateral leg symptoms with altered bladder or bowel function is cauda equina until proven otherwise yes or no

Answer 7

yes

Question 8

what examinations are needed

Answer 8

• rectal exam is mandatory

- urgent MRI is required to determine the level of prolapse