Cauda Equina syndrome is a rare disorder of spinal nerves and is caused by uncommon compression of its roots. It needs immediate attention to prevent permanent damage, which may result in bowel and bladder incontinence and a probable permanent paralysis of legs, sciatica, saddle sensory changes, etc.
Experiencing mild low back pain is common. It is not that serious and normally needs no surgery. A rare severe back pain may be a symptom of Cauda Equina syndrome, which requires hospitalization on emergency basis. It may also need surgical solutions.
Symptoms of Cauda Equina syndrome
Diagnosing Cauda Equina syndrome is very difficult, because the signs vary and may crop up slowly. They also resemble symptoms which are similar to other conditions. One needs to consult the doctor, whenever he/she notices the following symptoms:
- Numbness, weakness or pain in the legs, which may result in difficulties in leg movements
- Severe low back pain
- Change or loss of sensation in legs, back side of legs, buttocks, feet and inner thighs which become worse with the passage of time. An experience of saddle anesthesia all over the body.
- A sudden onset of sexual dysfunction
- Problem in the functioning of bladder or bowel, wherein the affected individual may find it difficult to retain or eliminate fecal material and urine.
Diagnosis of Cauda Equina syndrome
In the process of diagnosing Cauda Equina syndrome, the following are observed:
- The medical history about health, signs and activities of the affected person.
- Physical examination for assessment of strength, sensation, stability, reflexes, motion and alignment of the affected person. A blood test is also taken.
- Myelogram: To pin point the pressure on spinal cord nerves, X- ray of the spinal cord is taken after injecting the contrast material.
- A Computed tomography (CT) scan.
- A Magnetic Resonance Imaging (MRI) scan: Three dimensional images of spine are taken by using magnetic fields and computers.
Causes of Cauda Equina syndrome
Cauda Equina syndrome normally affects the adults. However, it can also affect children with birth defects of the spine and children who experience spinal injury. The common causes of Cauda Equina syndrome are:
- Narrowing of spinal canal
- Spinal lesion or tumor adjacent to the lower spinal cord
- Localized infection near the spinal cord caused by staphylococcus bacteria or tuberculosis bacteria.
- Inflammatory conditions of spine, including the Paget’s disease and ankylosing can cause a narrow spinal canal.
- Fracture or hemorrhage near the spinal cord (epidural abscess), partial dislocation (subluxation) of low back (lumbar spine) causing the compression of Cauda equine.
- Localized bleeding (epidural hematoma) and collection of blood, surrounding the nerves (epidural hematoma) at the low back area.
- Partial dislocation of low back
- Rupture in disk in lumbar area
- Birth defect such as arteriovenous malfunction
- Severe lumbar spine injury caused due to accidents
Treatment of Cauda Equina syndrome
- To relieve the pressure on spine nerves, prompt treatment of surgery is necessary to prevent a permanent damage to body organs such as paralysis of legs, sexual dysfunction, losing control on bladder and stomach etc. It should be carried out within 48 hrs from the onset of the signs.
- High doses of corticosteroids may become necessary depending on the cause of the Cauda Equina syndrome. It can reduce the swelling.
- If the cause was diagnosed as infection, then antibiotics will be prescribed to treat the condition
- The process of getting relief from the Cauda Equina syndrome will be slow and depends on the extent of damage that has occurred. Even if the surgery is successful, the recovery of control over the bladder and stomach may come after a period of a few years.
Adapting to live with Cauda Equina syndrome
Surgery does not always help to repair a permanent damage which has occurred. One has to learn to live with the Cauda Equina syndrome, along with the emotional and physical support available around them.
Depending on the limitations, one can avail the needed support from their family or from professionals. The required help can be availed from:
- A social worker
- An occupational or physical therapist
- A sex therapist
- A continence advisor
It may be difficult for others to understand the kind of difficulties and problems that one endures when affected by Cauda Equina syndrome. Hence it would be ideal to join a Cauda equine support group for a better support system.
Tips for those who suffer from bladder or stomach disorder and loss of function:
- Use catheter to empty the bladder 3 or 4 times a day.
- Clear the bowels waste with gloved hands. If it becomes necessary, glycerin or enemas can be used.
- Wear protective pads and pants to prevent leaks.
- Maintaining a good hygiene and drinking plenty of fluids will help to avoid urinary tract infections.
- Take regular guidance from the doctor for any medical problems.