Compression of the Cauda Equina
The cauda equina is a bundle of nerves at the base of the spine. If they become compressed, cauda equina syndrome will develop.
What is the cauda equina?
The cauda equina is a collection of nerves. They begin at the end of the spinal cord, which is called the conus medullaris. They then branch off, spreading down through the pelvis, buttocks and legs. Together the nerves resemble a horse's tail, which is why they are called the 'cauda equina' – which means 'horse's tail' in Latin.
The cauda equina nerves have a number of functions. Primarily, they enable function and sensation in the legs, feet, genitals, perineum, buttocks, bladder and bowel. Function and sensation in these body areas will be reduced (or completely lost) if the nerves become compressed.
Why would the cauda equina become compressed?
The cauda equina nerves can be compressed in various ways. The most frequent cause is a large prolapsed disc at the L4/L5 level. A prolapsed disc, also called a slipped disc, is when the inner part of a vertebral disc bulges out through the outer layer. A large protrusion can squash the nearby nerves.
There are also other medical conditions and injuries that can cause cauda equina compression. Some of these include: spinal tumour, spinal abscess, spinal stenosis, inflammation, ankylosing spondylitis and crushing injuries (for example, from a road traffic accident).
Cauda equina syndrome
As mentioned above, when the cauda equina nerves are compressed, sensation and function in certain areas will be adversely affected. This will lead to very noticeable symptoms, such as:
- Pain and numbness in the legs
- Numbness in the buttocks, perineum and genitals
- Strange sensation when urinating, and difficulty passing urine
- Sexual dysfunction with loss of sensation, inability to orgasm or maintain an erection
- Bowel dysfunction, with loss of sensation, constipation or incontinence
- Weakness in the legs and feet
When symptoms develop as a result of cauda equina compression, the patient has a medical condition called cauda equina syndrome. Cauda equina syndrome is a medical emergency that requires immediate surgical decompression to alleviate the pressure being placed on the nerves.
Delayed treatment of cauda equina syndrome
For cauda equina syndrome to be treated as quickly as possible, the patient is dependent upon medical practitioners making a timely diagnosis. Doctors must recognise the symptoms and send a patient for an emergency MRI scan. This will show whether there is compression of the cauda equina. If so, the patient must proceed to theatre for emergency decompression. If this action is not taken, there could be a case of medical negligence. Contact us for more information.
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