L-Spine
Cauda Equina Syndrome
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Cauda Equina Syndrome
, Epidural Compression Syndrome
See Also
Lumbar Stenosis
Pathophysiology
Massive
Central DI
sc protrusion
Compression of lumbar spinal nerve roots
Causes
Large
Central DI
sc
Hernia
tion
Lumbar Spinal Stenosis
Lumbar Spondylosis
with cauda equina compression
Post-procedure (iatrogenic)
Epidural Hematoma
Epidural Abscess
Symptoms
Bilateral
Sciatica
See also
Lumbar Stenosis
for extensive description
Dull aching pain in perineum,
Bladder
or
Sacrum
Radiation to Buttock and leg
Provoked by
Exercise
or prolonged standing
Relieved with rest or forward bending
Neurologic Changes
Saddle
Anesthesia
Bowel
or bladder
Incontinence
Acute
Urinary Retention
Signs
Loss of perineal
Sensation
or perineal reflex
Foot Drop
Ankle
dorsiflexion bilateral weakness
Absent
Ankle Jerk
Imaging (See Lumbar Stenosis)
L-Spine MRI
(preferred)
CT Myelography
Indicated if MRI contraindicated
Lab (Indicated if Epidural Abscess or other infection suspected)
Complete Blood Count
Erythrocyte Sedimentation Rate
(ESR)
C-Reactive Protein
(CRP)
Diagnosis
High yield exam findings
Altered perineal
Sensation
Abnormal rectal tone
Increased post-void residual
Management
Neurologic Deficits suggest Cauda Equina Syndrome
Immediate Neurosurgery
Consultation
Prognosis
Delay >72 hours risks permanent neurologic deficit
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