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Cauda Equina Symptoms but MRI shows no nerve pressure ?

AnonymousUserAAnonymousUser Posts: 49,671
edited 06/11/2012 - 8:27 AM in Back Surgery and Neck Surgery
I have had my L5-S1 micro-discectomy on 14-Nov 2008 and I was doing great till 45 days elapsed. I was still in a bit of leg pain though but overall my condition was better.

After this period, I started on spine strengthening exercises ( I myself asked the doc for these exercises Sad ) and since then it has been a downhill progress.

After 3 days of such exercises I felt a bit of nerves tightening and then loosening in my low back area for 5-6 seconds. From the next day, the symptoms started with loss of feeling in the bladder and bowel and then considerable loss of sensation in my legs but motor function is intact. I also have numbness in my groin region and also a bit of saddle anesthesia. My back is also numb and the back pain I feel is as if it is a distant pain ( feels like stupid of me to tell it this way !! ). There is also a lot of throbbing in my left leg.

The repeat MRI shows no pressure on the nerve roots but a bit of swelling in the soft tissues at the L5-S1 level.

My surgeon ( though famous ) refuses to believe me and tells me that since I still have control over bladder and bowel and that only the feeling is missing, and also since I am able to walk, its fine !! He says he will do something is any of this function is compromised !!!!!!!!!!!

I have read a lot of material on cauda equina and all my symptoms seem relevant to it, though slowly developing. I am scared that the situation will further deteriorate.

1) I am not able to understand how the MRI can show no pressure on the nerve roots and still I have symptoms of nerve root pressure.

2) Can the soft tissue swelling near L5-S1 level cause such symptoms and will I regain the sensations lost in my bladder, bowel and the legs ?

I went to a different neuro-physician and he suggested that the symptoms should slowly come down within 2 weeks and that this might have been caused by improper exercise and also the soft tissue swelling.

Anyone having any advise or information, please let me know.

Take Care All,
L5-S1 micro-discectomy for large central disc prolapse on 14/11/08.
Disc Bulge with small annular tear at L4-5 level.


  • That's rough you have problems now with that area. I sometimes just feel pressure and then I go to the washroom. And I have feeling as it comes out and sometimes dribble but was told that is a side effect of the steroids. But because I can feel on the inside of my thighs and can stand on my toes it's still conservative measures for me. I haven't had surgery yet and wish I could help you but hopefully you'll get the feeling back in 2 weeks or so like the other Neuro said. I hope you get the feeling back and the soft tissue swelling goes down. Take care. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • Hi MAK,

    I am sorry for your troubles. But as disturbing as they seem, as longs as you retain full bowel and bladder control, you don't really have Cauda Equina syndrome, which is considered an emergency. So if your surgeon does not worry too much about it, maybe it is in fact soft tissue swelling, caused by exercises. So take it easy with that, and if your symptoms continue to bother you or get worse, go and see your surgeon, or if necessary, go to the ER.

    Best wishes,

  • I had full loss of bladder control and they did emergency surgery (I literally went to the bathroom and didn't feel a thing). I was also almost totally numb in the vaginal area and buttocks. They did diagnose this as cuada equina. I think all doctors are different, but if the symptoms get worse I would DEMAND him to pay attention, or if they are really bad, go immediately to the ER (if you lose total control it can become permanent). After my surgery I did develop some tingling in my groin area and had some problems with retaining urine, but never totally lost control, and at that point no one was worried and said my nerves were just inflammed. Yu are the only one that can judge your body...and if you feel it gets worse, then it needs to be attended to..I will pray for you and hope it gets better in a few weeks! If you want to PM me and ask any questions please do, as I have had 3 surgeries for cuada equina symptoms.
  • My surgeon told me the same thing about there being no reason for the leg pain or the numbness in the bowels. After surgery (imagine that) I could feel my bowels again all though he still doesn't see where the butt and leg pain can be coming from.
  • My surgeon also didn't believe me at first. Said that shouldn't have happened. But it did. So after 4 lumbar surgeries and no relief....... I can't feel when to go and can't give it up. Neurologist called it incontinence but someone else said retention issue. Now they are going to MRI my neck and see if my bowel,bladder, foot neuropathy, and arms issues come from there. I hope they figure this out soon.
    MAK I just don't think they know enough about this yet. To them it makes no sense apparently but we must keep pushing them to figure it out cause I don't want to live like this forever.
  • Hi All,

    This indeed is a great forum. Thanks for all your support and views.

    I feel so horrid now looking back because my condition was perfect save for some trouble with pricking pain in my legs just 1 month ago.

    One of the things I realise now is that you should never get operated by a surgeon if you dont trust him even though he may be the best in the world !! The surgeon who did my surgery was the best in my area but the way he talked to me before surgery made me dis-trust him and but due to my family's word I had to go with him.

    Even after the surgery, my mom kept telling me the you shud have a positive attitude but somehow negative thinking kept bothering me all along because of the surgeon saying that I might lose urine and sexual control even after the surgery !

    I contacted my new neuro with the new conditions and he suggested a repeat "MRI with contrast" focussing on cauda-conus regions. I am planning to get it done on Tuesday to see if it shows up anything.

    Will keep you posted about the results.

    Really feel bad for all of us who have to go through these troubles because of some stupids who call them as doctors.
    I might seem harsh but these doctors should atleast take us seriously when we tell them our symptoms.

    Its as if my surgeon believes that cauda equina occurs only because of central disc prolapse and nothing else can cause it !!

    And yes, I also dont want to live like this forever as I just got engaged and was and still am looking forward to some happy times in the near future. I just hope these symptoms start subsiding from now (keeping fingers crossed).

    God help all of us !

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