Understanding Cauda Equina Syndrome

Cauda equina syndrome occurs when your cauda equina, a bundle of nerve fibers at the bottom of your spinal cord, is pinched or irritated. This aggravation can be caused by a number of disorders, including a herniated disc, a tumor, spinal stenosis, or inflammatory conditions such as ankylosing spondylitis.

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Cauda Equina Syndrome Your cauda equina nerve fibers are responsible for the control of your bladder.
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Cauda Equina Syndrome Video

Our video walk through can help you better understand this rare ailment that is considered to be a medical emergency.

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Video highlights

Cauda equina anatomy
Pictured below is the lumbar area of your spine (commonly referred to as the lower back). Your nerves are pictured in purple.

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Lumbar Spine

Your spinal cord runs from the base of your skull to the top of your lumbar spine. As it reaches your lumbar spine, it branches into several nerve fibers, known as the cauda equina, which continue throughout your lower body.

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Lumbar Spine

Your individual nerves exit through small holes in your lumbar spine called foramina (pictured above). Your sacrum, legs, and feet are innervated by the individual nerves from this part of your spine as they run downward throughout your body.

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Cauda Equina Nerve Fibers

These nerves communicate sensory and motor nerve messages between your central nervous system and your pelvis and lower limbs. They are responsible for the control and sensory function of your bowel, bladder, genitals and saddle area (where your body would touch a saddle if you were riding a horse), and your legs.

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Causes of cauda equina syndrome
Cauda equina syndrome can be caused by any condition in your lower spine that compresses the nerves in your lumbar spinal canal.

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Cauda equina syndrome is often caused by disc herniation.

The most common cause is a massive disc herniation in your lower spine, shown above. Less common causes include tumors, spinal stenosis, inflammation, infection within your spinal canal, or an injury to your spine.

See Lumbar Herniated Disc: Causes and Risk Factors

Symptoms
Symptoms of cauda equina syndrome often vary. They may come on suddenly, or they may occur gradually over many years—depending on the degree of nerve irritation.

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The cauda equina communicates sensory and motor nerve messages between the central nervous system, pelvis, and lower limbs.

Common symptoms include:

  • Severe low back pain
  • Neurological problems in your saddle region
  • Urinary or bowel incontinence
  • Motor weakness
  • Difficulty walking
  • Paralysis

See Lower Back Pain Symptoms, Diagnosis, and Treatment

Your main takeaway from this walk through should be that acute cauda equina syndrome is a rare but serious medical emergency which usually requires decompression surgery on the spine within 24 hours. If left untreated, it can result in paralysis, loss of sensation below your lumbar spine, and permanent loss of bladder and bowel control.

See How Decompression Surgery Is Performed

Learn more:

When Back Pain May Be a Medical Emergency

Understanding the Clinical Diagnosis of a Herniated Disc

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