A Surgical Emergency: “Cauda Equina Syndrome”

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Sarkar S*, Akther SMQ, Mazumder U, Khan MN, Dey A



Cauda equina syndrome (CES) is a serious neurologic condition in which neurological dysfunction affects the lumbar and sacral nerve roots within the vertebral canal. The nerves of the Cauda equine supply the muscles that control the bladder, bowel and the legs and the dysfunction of the sacral and lumbar nerve roots within the vertebral canal producing impairment of bladder, bowel or sexual function and perianal or saddle numbness. Elucidation of these findings in the clinical examination is crucial.Recognition of CES is not only important to Neurosurgeons and Spine surgeons, but also to primary care practitioners, emergency room physicians, physiotherapists and allied health care professionals involved in management of back pain. It is an important diagnosis from a clinical and medico-legal perspective. Undiagnosed, delays to diagnosis or a delay in treatment can have a disproportionate medico- legal impact. This article aims to provide an understanding of CES with illustrations of its common causes and mimics. The number of potential aetiologies is vast but the most common causes are disc herniation, tumours, infection, spinal stenosis, inflammatory causes and vasculature occlusion. Early surgical decompression is advocated by most authors to best aid patient’s recovery and reduces long term disability.

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