Cauda Equina Syndrome

(CES; Compression of Spinal Nerve Roots; Syndrome, Cauda Equina; Spinal Nerve Roots, Compression)

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Definition

Cauda equina syndrome (CES) is when the nerve roots at the base of the spinal cord are compressed. Known as the cauda equina, this bundle of nerves is responsible for the sensation and function of the bladder, bowel, sexual organs, and legs. CES is a medical emergency. If treatment is not started to relieve pressure on the nerves, function below the waist may be lost.
Cauda Equina
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Causes

A common cause of CES is injury of a spinal disk on the nerve roots. A spinal disk is a semi-soft mass of tissue between the bones of the spine. These bones are known as the vertebrae. The disks act as the spine’s shock absorbers. When a disk spills out into the spinal canal, it can press against the bundle of nerves, causing CES. This syndrome may also be caused by:
  • Accident that crushes the spine, such as a car accident or fall
  • Penetrating injury, such as a knife or gunshot wound
  • Arthritis, such as ankylosing spondylitis
  • Complications from spinal anesthesia
  • Mass lesion, such as a blood clot
  • Complications from cancer
  • Side effect of certain medications

Risk Factors

Factors that may increase your risk of developing CES include:
  • History of back problems, such as lumbar spinal stenosis
  • Degenerative disk disease
  • Birth defects, such as a narrow spinal canal or spina bifida
  • Hemorrhages affecting the spinal cord
  • Arteriovenous malformation
  • Spinal surgery or spinal anesthesia
  • Lesion or tumor affecting the spinal bones, spinal nerve roots, or cerebrospinal fluid (CSF)
  • Infection affecting the spine
  • Manipulation of the lower back—rarely

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