What is Cauda Equina Syndrome?
Cauda Equina Syndrome: Delivering Expert Care for a Delicate Condition at King’s Spine Centre!
Cauda Equina Syndrome is an uncommon yet serious condition that takes place when the bundle of nerves at the base of your spine, known as the cauda equina, becomes compressed or damaged. This can lead to severe back pain, weakness, numbness, and even loss of bladder or bowel control, profoundly impacting your daily life. Prompt diagnosis and treatment are pivotal to preventing lasting complications.
At King’s Spine Centre, we understand the urgency and sensitivity of this condition. We offer comprehensive treatment for cauda equina syndrome, including surgical decompression to relieve pressure on the nerves. Our experienced team of spine surgeons and specialists is dedicated to providing the supreme care and helping patients to win back their mobility and quality of life.
What is Cauda Equina Syndrome?
Cauda Equina Syndrome occurs when a group of nerve roots at the base of the spinal cord (cauda equina) becomes compressed. These nerve roots play a vital role in enabling movement and sensation in the legs and controlling functions of the bladder.
Nerves act as the body’s communication network, sending and receiving electrical signals throughout. When the nerves are compressed, it disrupts their function. Just as utility workers act swiftly to restore power, healthcare providers and surgeons work diligently to relieve pressure on the nerves and restore their function.
Types of CES
Cauda equina syndrome is classified into two types:
Incomplete Cauda Equina Syndrome (CES-I): This form results in a reduced ability to sense or feel urgency in the bladder and bowels. Individuals may not realize when they need to urinate or have a bowel movement. This type affects approximately 40% of those diagnosed with cauda equina syndrome.
Complete Cauda Equina Syndrome (CES-R): In this more severe form, individuals experience either urinary and/or bowel retention or incontinence. Retention means the inability to urinate or pass stool, while incontinence refers to the loss of control over these functions. This type affects around 60% of people with the condition.

How Rare is Cauda Equina Syndrome?
Cauda equina syndrome is estimated to affect approximately 1 in 30,000 to 100,000 people globally each year and occurs in about 3% of all cases involving herniated discs.
What Causes Cauda Equina Syndrome?
Cauda equina syndrome can result from various causes, including a herniated disc, which acts as a cushion between the vertebrae and provides space for nerves to pass along the spinal cord to different parts of the body. Other causes include tumors, infections, spinal fractures, or a narrowing of the spinal canal.
Traumatic events like car accidents falls from significant heights, or penetrating injuries like gunshot wounds or stabbings can also lead to this condition. In some cases, congenital spinal abnormalities in children may lead to cauda equina syndrome.
Cauda Equina Syndrome Symptoms
Diagnosing cauda equina syndrome can be challenging because its symptoms often overlap with other conditions and may develop gradually.
If you experience any of the following early symptoms of cauda equina syndrome, it is essential to seek medical attention immediately:
- Severe lower back pain or leg pain (sciatica)
- Pain, weakness, or numbness in one or both legs, making it difficult to walk, stand, or rise from a chair.
- Paresthesia, which includes sensations of tingling, prickling, or burning in the lower limbs.
- Saddle anaesthesia, characterised by a loss of feeling or altered sensations in areas of the body that would touch a saddle, including the buttocks, inner thighs, backs of the legs, or feet.
- Bladder or bowel dysfunction, such as difficulty urinating, loss of control, or incontinence.
- Sudden onset of sexual dysfunction.
- Abnormal reflexes or paralysis in the lower body.
Prompt evaluation and treatment are critical to avoid long-term complications. If you notice any of these symptoms, consult a healthcare provider without delay.
How to Diagnose Cauda Equina Syndrome?
To diagnose cauda equina syndrome (CES), a doctor may use the following:
- Medical History: Questions about your health, symptoms, and activities.
- Physical Exam: Evaluation of strength, reflexes, sensation, and mobility, sometimes with blood tests.
- MRI Scan: Detailed 3D imaging of the spine using magnetic fields.
- Myelogram: X-ray or CT scan with contrast dye to detect nerve or spinal cord pressure, used if MRI is unavailable.
- Anal Muscle Testing: Assessment of rectal and anal muscle function.
- Electromyography (EMG): Measures muscle response to nerve signals.
- Nerve Conduction Studies (NCS): Evaluates nerve function and potential damage.

Treatment for Cauda Equina Syndrome
Appropriate cauda equina syndrome treatment is essential to prevent permanent nerve damage and restore normal function. The treatment strategy depends on the acuteness of the condition, the hidden cause, and how quickly it is diagnosed.
Surgical Treatment
Surgery is the primary and most effective treatment for cauda equina syndrome, particularly when nerve compression is involved. The aim is to relieve pressure on the cauda equina nerves to restore function and prevent lasting complications.
Lumbar Laminectomy: This procedure involves removing a portion of the vertebra (the lamina) to create more space in the spinal canal and relieve pressure on the compressed nerves. It is commonly performed for CES caused by conditions such as spinal stenosis or trauma.
Decompression Surgery: This category includes other procedures like discectomy, where a damaged or herniated disc pressing on the nerves is removed. Tumour removal or fragment excision may also fall under decompression surgery, depending on the cause of the compression.
Timing is Critical: Surgery performed within 24-48 hours of symptom onset provides the best chances of recovery. Delays in treatment elevate the risk of permanent nerve damage, leading to issues like incontinence or paralysis.
Non-Surgical Treatment
In some cases, non-surgical approaches may complement surgical interventions or be used as temporary measures, especially when CES is caused by infection, inflammation, or other reversible factors.
Medications:
- Anti-inflammatory drugs, such as corticosteroids, help reduce swelling and alleviate pressure on the nerves.
- Antibiotics or antivirals are prescribed when CES is caused by an infection.
- Pain relievers can manage discomfort during recovery.
Bladder and Bowel Management: Urinary retention may require catheterization, while bowel function can be managed with dietary adjustments or medications.
Physical Therapy: This can play a vital role after surgery, aiding in restoring mobility, rebuilding strength, and preventing complications.

Seek Comprehensive Cauda Equina Syndrome Treatment and Care at King’s Spine Centre
At King’s Spine Centre, we understand that treating cauda equina syndrome requires a personalized approach tailored to each patient’s needs. Our expert team prioritizes early diagnosis and offers advanced surgical solutions for severe cases, complemented by non-surgical therapies to support recovery and symptom management.
Beyond medical treatment, we guide patients on lifestyle modifications, including improved posture, tailored exercises, and activity adjustments, to promote long-term spinal health and prevent recurrence.
Schedule an appointment to experience King’s Spine Centre’s dedicated services, which help patients achieve the best possible outcomes.