Cauda equina syndrome is considered a neurosurgical emergency and is an indication for surgical treatment as soon as possible in order to minimize the risk of permanent damage.
Pathophysiology
Cauda equina syndrome involves compression of the Cauda equina, which in most cases is caused by a Herniated disc, but may also have other causes, such as decompensated Spinal canal stenosis or an Abscess.
The causes most frequently reported in the literature are as follows[^1]:
Pathology | Frequency (%) |
Herniated disc | 45 |
Tumor | 29 |
Infection | 28 |
Spinal canal stenosis | 21 |
Inflammatory | 12 |
Vascular | 11 |
Symptoms
Depending on its severity, cauda equina syndrome may present clinically with the following variable symptoms[^1]:
Flaccid paresis of the lower extremities in the distribution of the affected nerve roots.
Dermatomal or nonspecific sensory disturbances
Dermatomal or nonspecific pain.
Bladder emptying disorders
Sphincter dysfunction
Erectile dysfunction
Diagnostic workup
The gold standard for imaging assessment of cauda equina syndrome is MRI imaging.
