Cauda Equina Syndrome (CES)
We’d like to bring to your attention information about a very debilitating condition at the request of Caroline – one of Bad Backs subscribers. I’m sure very few of us have heard of this serious condition.
Cauda Equine Syndrome (CES) can be difficult to diagnose. It’s rare and its symptoms mimic those of other conditions. Often the sufferer can no longer work due to the severe pain, loss of muscle power, severe depression or social embarrassment.
We agree with Caroline that both public and medical awareness of CES needs greater exposure to minimise those cases that can be avoided by prompt treatment and better early diagnosis.
‘Cauda Equina’ is so called because it resembles the tail (Latin, cauda) of a horse (Latin, equus). The Cauda Equina is the sack of nerve roots at the lower (lumbar) end of the spinal cord. CES occurs when the nerve roots are compressed and paralysed, cutting off sensation and movement. As a result, the nerves supplying the muscles of the legs, bladder, bowel and genitals do not function properly. Patients experience numbness, loss of sensation and severe pain in the legs, buttocks and pelvic region to varying degrees. CES is considered a surgical emergency, because if left untreated it may lead to permanent loss of bowel and bladder control and paralysis of the lower part of the body.
What are the causes of Cauda Equina Syndrome?
Causes of Cauda Equina damage can be separated into those that are present at birth (congenital), and those acquired after birth.
Congenital causes of CES:
- Spina bifida (abnormality in closure of spinal canal)
- Tumours of the cauda equina
Acquired causes of CES:
- Injury (spinal fractures)
- Secondary to medical procedures
- Intravertebral disc herniation
- Tumours of the cauda equina
- Vascular (blood vessel) problems of the cauda equina
- Infections (eg CMV, cytomegalovirus) of the cauda equina
Diagnosis & treatment
Although you need early treatment to prevent permanent problems, CES may be difficult to diagnose. Symptoms vary in intensity and may evolve slowly over time.
Symptoms may be:
- Severe pain in the back, buttocks, perineum (saddle rea), genitals, thighs, legs.
- Loss of sensation – often tingling or numbness in the saddle area.
- Weakness in legs
- Bladder/bowel/sexual dysfunction
- Loss of reflexes
To diagnose CES your doctor will probably evaluate your medical history, give you a physical examination and order multiple imaging studies.
By increasing awareness of this condition and demanding more research and more treatment options, the CES Support Group hope to improve the quality of life for current CES patients and prevent future generations from suffering from CES.
