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Cauda Equina Syndrome CES

The Cauda Equina, which is Latin for 'horses tail', is the bundle of nerve fibres at the base of the spinal column which radiate out to the legs and lower areas of the abdomen and control movement and feeling. Pressure on this bundle of nerves causes distinctive symptoms including pain, sensory loss in the sacral region, weakness in the legs and loss of bladder control which can be confirmed by diagnostic techniques including MRI scan, Myelography and CAT scans.

The most common cause of Cauda Equina Syndrome results from a prolapsed disc pressing on the bundle of nerve roots at the base of the spinal column.

This condition is frequently referred to as rare however prolapsed disc problems are very common and about 2% of lumbar disc protrusions result in pressure on these nerves.

The surgical treatment of an acute nerve compression is usually regarded as a medical emergency due to the potential for serious damage and consequences to the victim if treatment is delayed.

Delay in treatment can cause irreparable damage and it is incumbent on treating physicians to ensure that they are familiar with the 'red flag' signs of this condition and ensure surgical intervention by a competent neurosurgeon at the first possible opportunity.

Major symptoms of this condition may include:

  • Localised low back pain with tenderness to applied pressure
  • Abnormal reflexes which typically include loss or diminution of reflexes
  • Pain in the legs or radiating to the legs
  • Loss or reduction of sensation in the 'saddle' area which may show skin breakdown
  • Muscle weakness or muscle wasting if CES has been present for a lengthy period
  • Incontinence

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