What is Cauda Equina Syndrome ?
Low back pain influences a large number of individuals consistently. Cauda equina disorder is a condition which happens when the nerves at the base of the spinal cord are crushed together.
Cauda equina syndrome (CES) is a rare. CES is not related to gender or race. CES can influence both physically and inwardly, especially on the off chance that it is chronic. Cauda equina disorder is a clinical region that pulls in a high danger of suit.
CES affects a heap of nerve roots called cauda equina (Latin for horse’s tail). Cauda equina syndrome occurs when the nerve roots of the cauda equina are compress and disrupt motor and sensory function to the lower extremities and bladder. Nerve roots that control the capacity of the bladder and entrail are particularly powerless against harm.
Keep reading to learn what symptoms the condition causes, how it’s managed, and more.
- Cauda Equina Syndrome is some time knows as CES Disease and Cauda Equina Disorder
Which Age Group Affect Cauda Equina Syndrome Disease?
It occurs primarily in adults, although trauma-related CES can affect people of all ages.
- Teen Boy and Girl, Man, Women, Old Man and Women
Cauda Equina Syndrome Sign and Symptoms
Cauda Equina Disorder symptoms can set aside a long effort to create and may fluctuate in severity. CES can cause an assortment of symptoms, including:
- Severe low back pain
- weakness, pain, or a loss of sensation in one or both legs (such as a loss of motor function in legs or difficulty in walking)
- bowel incontinence (such as a loss of control)
- loss of reflexes in your lower limbs
- Powerlessness to feel anything in the body regions that would sit on a saddle
- Sexual dysfunction that has gone ahead abruptly
- loss or reduction of reflexes
- Inability to urinate, or to hold urine or feces
Medical history implications:
- A history of cancer
- Recent violent injury to the back
- Current severe infection
- Recent lumbar spine surgery
Causes of Cauda Equina Syndrome
Cauda equina Syndrome is most usually caused by a gigantic disc herniation in the lumbar spine (low back). Symptoms vary and may come on slowly. There are various conditions that can cause Cauda equina syndrome. A common cause of CES is injury of a spinal disc on the nerve roots.
The following are possible potential causes of Cauda equina Syndrome that describe red flags:
- Severe low back pain
- Numbness, weakness, or Pain in one or both legs
- Lesions or tumors on your lower spine
- Narrowing of the spinal canal
- Spinal infections or inflammation
- Lumbar disc herniation (most commonly in L4/5 and L5/S1)
- Sexual dysfunction
- Lumbar spinal canal stenosis
- Spinal anesthesia (trouble feeling anything in the areas of your body that would sit in a saddle)
- Arteriovenous malformation
- Birth abnormalities or birth defects
- Tarlov cysts
- Facet joint cysts
- Spinal fracture or dislocation
- Accident that crushes the spine, such as a car accident or fall
- Tuberculosis (Pott disease)
- Spinal hemorrhages or fractures
- Primary CNS malignancies
- Aortic dissection
Cauda Equina Syndrome Red Flags
Risk factors for developing Cauda Equina Syndrome include:
- Individuals with a history of spinal conditions (that cause back pain), such as lumbar spinal stenosis
- Degenerative disc disease
- Infection of the spine
- A history of cancer
- Individuals with a history of spinal surgery
- Degenerative joint disease (osteoarthritis)
- Having a genetic predisposition for a herniated disk
- Paget disease
- Spina bifida (Birth defects, such as a narrow spinal canal)
- Instability or deformity of the spine
- Spinal surgery or spinal anesthesia
- Hemorrhages affecting the spinal cord
- Spinal arteriovenous malformations
- Coagulopathy (easy bleeding), which is a bleeding disorder that decreases the body’s ability to form blood clots (or coagulates)
- In rare cases, spinal manipulation of the lower back
- Lesion or tumor affecting the spinal bones, spinal nerve roots, or cerebrospinal fluid (CSF)
Cauda Equina Syndrome can develop suddenly even without these risk factors.
How is Cauda Equina Syndrome Diagnosed?
Your doctor will want a detailed list of all your symptoms, including when they started and their severity and Medical history. Your doctor will do a physical examination. They will test the stability, strength, alignment, and reflexes of your legs and feet.
Magnetic resonance imaging (MRI):
- You may be advised to have an MRI scan of your lower back.
- An MRI uses magnetic fields to help produce produces images of the spinal cord, nerve roots and surrounding areas.
- MRI scan will give a more detailed look at the spinal cord and the structures surrounding it.
- A myelogram is an X-ray of the spinal canal following injection of a contrast material into the surrounding cerebrospinal fluid spaces.
- Myelogram test is a special dye is injected into the tissue surrounding your spine.
- It can show displacement on the spinal nerves due to herniated discs, bone spurs, tumors, etc.
Cauda Equina Syndrome Treatments
The surgery prevents pressure on the nerves from reaching the point at which damage is irreversible. Surgery help prevent the permanent damage such as paralysis of the leg, loss of bowel and bladder control, sexual function or other problems. Talk with your doctor about the best therapy plan for you.
Treatment options include the following:
Discectomy is the surgery in which the compressed nerves are removed from the portion of the disc. To remove part of an intervertebral disc that is putting pressure on the spinal cord or. To expel some portion of an intervertebral disc that is putting pressure on the nerve root or spinal cord. The window of bone is removed to uncover the nerve root and plate. The part of the cracked disc compacting the spinal nerves is deliberately removed.
If CES is due to cancer, radiation therapy may be an option. Your doctor may also treat the underlying cause of CES.
Spinal decompression for stenosis removes the bone spurs and ligaments compressing the nerves. The surgeon removes the bone that forms the roof of the spinal canal. Tumors and other lesions can also be removed.
Laminectomy is one of the most common back surgeries. Most laminectomies are fulfilling with general anesthesia and mechanical ventilation. Laminectomy is a surgery in which a surgeon removes portion or all of the vertebral bone (lamina).
For long-term treatment,
your doctor may prescribe drugs such as,
- Pain relievers after surgery such as oxycodone (OxyContin)
- Over-the-counter pain relievers, such as ibuprofen (Advil) or acetaminophen (Tylenol), can be used for daily pain relief.
- Corticosteroids are prescribed to reduce the inflammation and swelling around the spine
- Hyoscyamine (Levsin), tolterodine (Detrol) and oxybutynin (Ditropan) for better bladder and bowel control
What you should do in Cauda Equina Syndrome?
- Get regular exercise for cauda equina syndrome. Exercise build-up the muscles that support your back and helps keep your spine flexible.
- To become familiar with everything you can about dealing with the condition
- You may want to join a cauda equina syndrome – CES support group.
- You may want to get help from an occupational therapist, social worker, continence advisor, or sex therapist.
- Involve your family in your care.
Is surgery required for Cauda Equina Syndrome?
The time of onset of symptoms is difficult to specify. Thus it is difficult to define the delay between symptoms and surgery. When there is pressure on the cauda equina causing loss of sphincter control it would be understandable to think that the ideal treatment would be to remove the pressure as soon as possible with surgery.
The surgery should be done within 24 or 48 hours of the onset of serious symptoms. A CES diagnosis is usually follow by surgery to relieve pressure on the nerves. But, Cauda equina syndrome is a medical emergency that calls for urgent surgical intercession.
What treatment options are there after surgery?
After surgery, your doctor will see you periodically to check on your recovery. Full recovery from any CES difficulty is possible. If you continue to have symptoms, be sure to tell your doctor.
- A physical therapist can help you regain your strength and give you exercises to help improve your stride.
- An occupational therapist may also be helpful if everyday activities, such as getting dressed, are affected by CES.
- Specialists to help with incontinence and sexual dysfunction may also be part of your recovery team.
Managing Bladder and Bowel and Sexual Function
Bladder and bowel task is automatic, yet the parts under deliberate control might be lost in the event that you have Cauda Equina Syndrome.
Cauda Equina Syndrome can cause pain in the lower back or between the legs, bladder or bowel control and sexual function.
Therefore, Here some guidelines for managing bladder and bowel dysfunction:
- Empty the bladder completely with a catheter 3-4 times each day.
- Drink plenty of fluids and practice regular personal hygiene to prevent urinary tract infection.
- Check for the presence of waste regularly and clear the bowels with gloved hands.
- Use protective pads and pants to prevent leaks.
Complications of Cauda Equina Disorder
If the primary treatment is delay, the following complications may arise such as:
- Bladder, sexual and bowel dysfunction
- Abnormalities in sensory systems
Home Treatments for Cauda Equina Syndrome
Some home remedies like an ice sack, warming pad, rub or massage or a long hot shower can help you.
The nutritional supplements glucosamine and chondroitin have been recommended as nutritional supplements. But, There is no perfect home remedy or treatment available at that time.
Cauda Equina Syndrome Prevention
Cauda Equina Syndrome is a rare complication. Prevention of Cauda Equina Syndrome is focuse on early diagnosis by identifying the symptoms described in this article. But, averting infections and injury is a lot of fundamental to maintain a strategic distance from these reasons for Cauda Equina Syndrome. Therefore, There are no present rules to counteract CES.
Cauda equina syndrome is a surgical emergency. Cauda equina syndrome is a hazy area and there is no agreement on which signs and side effects ought to be followed up on.
If you have cauda equina syndrome, you may need urgent surgery to remove the material that is pressing on the nerves. An understanding of cauda equina syndrome is important not only to orthopedic surgeons and neurosurgeons.