Today is Spinal Cord Injury Awareness Day; so let’s take a look at cauda equina syndrome (CES).
Cauda equina syndrome is a rare and severe type of spinal stenosis where the bundle of nerve roots at the lower end of the spinal cord become compressed. Typically this compression is from a disc prolapse, but can be caused by other conditions, such as trauma, arthritis or other bone disease.
This causes a range of problems, including saddle anaesthesia (numbness in the skin around the anus and undercarriage); loss of control or sensation for the bowel or bladder or dysfunction or loss of sensation for the sexual organs.
These more serious symptoms may present alongside more typical pain, numbness or pins and needles into the legs; with CES particularly liking causing symptoms into both legs at the same time. Depending on the cause, these problems can come on suddenly, or gradually; and may plateau or continue to progress.
If left untreated, these symptoms may rarely become critical, or permanent; but we have no reliable way of telling if that is going to be the case. Consequently suspicion of CES requires emergency hospital admission and scans; and will often be operated on as a matter of some urgency.