Cauda Equina Syndrome
Although leg pain is common and usually goes away without
surgery, cauda equina syndrome, a rare disorder affecting the bundle of nerve
roots (cauda equina) at the lower (lumbar) end of the spinal cord, is a
surgical emergency.
An extension of the brain, the nerve roots send and receive
messages to and from the pelvic organs and lower limbs. Cauda equina syndrome
occurs when the nerve roots in the lumbar spine are compressed, cutting off
sensation and movement. Nerve roots that control the function of the bladder
and bowel are especially vulnerable to damage.
If patients with cauda equina syndrome do not seek immediate
treatment to relieve the pressure, it can result in permanent paralysis,
impaired bladder and/or bowel control, loss of sexual sensation, and other
problems. Even with immediate treatment, some patient may not recover complete
function.
Causes
Cauda equina syndrome may be caused
by a herniated disk, tumor, infection, fracture, or narrowing of the spinal
canal.
Although early treatment is required
to prevent permanent problems, cauda equina syndrome may be difficult to
diagnose. Symptoms vary in intensity and may evolve slowly over time.
See your doctor immediately if you
have:
- Bladder and/or bowel
dysfunction, causing you to retain urine or be unable to hold it.
- Severe or progressive problems
in the lower extremities, including loss of or altered sensation between
the legs, over the buttocks, the inner thighs and back of the legs (saddle
area), and feet/heels.
Treatment
If you have cauda equina syndrome, you may need urgent
surgery to remove the material that is pressing on the nerves. The surgery may
prevent pressure on the nerves from reaching the point at which damage is
irreversible.
Living With Cauda Equina Syndrome
Surgery
may not repair permanent nerve damage. If this occurs as a result of cauda
equina syndrome, you can learn how to improve your quality of life.
Some suggestions:
·
In
addition to medical personnel, you may want to get help from an occupational
therapist, social worker, continence advisor, or sex therapist.
·
Involve
your family in your care.
·
To
learn all you can about managing the condition, you may want to join a cauda equina
syndrome support group.
Managing Bladder and Bowel Function
Some
bladder and bowel function is automatic, but the parts under voluntary control
may be lost if you have cauda equina syndrome. This means you may not know when
you need to urinate or move your bowels, and/or you may not be able to
eliminate waste normally.
Some general recommendations for managing bladder and bowel
dysfunction:
·
Empty
the bladder completely with a catheter 3 to 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. You
may want to use glycerin suppositories or enemas to help empty the bowels. Use
protective pads and pants to prevent leaks.
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