Cauda Equina Syndrome

The cauda equina is a bundle of nerves at the lower end of the spinal cord. It is vital for nerve communication to the legs, feet and pelvic organs. In cauda equina syndrome (CES), the nerves become compressed or pinched. It requires urgent treatment to prevent permanent damage such as incontinence and leg paralysis.

Signs and symptoms

Symptoms of CES can develop slowly and may include:

  • Severe lower back pain
  • Pain, numbness or weakness in one or both legs
  • Severe or worsening altered sensations in the legs, buttocks or feet
  • Difficulty with bladder or bowel functions, such as retention or incontinence
  • Sudden sexual dysfunction

Potential Causes

CES may be the result of a herniated disc, spinal stenosis, cancer, trauma, epidural abscess or an epidural hematoma. 


Many other conditions can cause the same symptoms, so it is important to check with your doctor for an accurate diagnosis. Only a doctor experienced in recognizing the exact combination of symptoms that indicate CES can make a firm diagnosis.

Diagnosis of CES starts with a physical exam and medical history. Other procedures and tests may be needed to diagnose this condition, including: (MRI), or (CT).

Treatment options

Cauda equina syndrome is treated by performing a laminectomy surgery to decompress or release the nerves. During surgery, you will be positioned face down on a padded frame/bed. By opening the skin and muscle layers, the spine is exposed. The entire roof (laminectomy) is removed and the nerves are released. When surgery is done, the retractors are removed, allowing the muscles to cover the exposed canal, and the skin is closed. There may still be permanent damage to the nerve despite surgery, and patients may continue to have symptoms. 


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