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Cauda equina syndrome

Last reviewed: 5 Oct 2024
Last updated: 06 Feb 2023

Summary

Definition

History and exam

Key diagnostic factors

  • bladder dysfunction
  • lower limb weakness
  • saddle paresthesia/anesthesia
  • bowel dysfunction
Full details

Other diagnostic factors

  • low back pain
  • sciatica
  • sexual dysfunction
Full details

Risk factors

  • lumbar disk herniation
  • spinal trauma
  • spinal surgery
  • spinal epidural abscess
  • anticoagulation therapy
  • spinal stenosis
  • spinal tumor
  • ages under 50 years
Full details

Diagnostic tests

1st tests to order

  • MRI lumbar spine without IV contrast
  • CT lumbar spine without IV contrast
Full details

Tests to consider

  • CT myelography of the lumbar spine
  • urodynamic testing
  • digital rectal exam
Full details

Treatment algorithm

ACUTE

confirmed CES

Contributors

Authors

Kenneth F. Casey, MD, FACS

Clinical Associate Professor

Neurosurgery

Michigan State University

Clinical Associate Professor

Physical Medicine and Rehabilitation

Wayne State University School of Medicine

Detroit

MI

Disclosures

KFC declares that he has no competing interests.

Peer reviewers

Kevin Barraclough, MA, FRCP, FRCGP, LLB

GP

Painswick Surgery

Painswick

Gloucester

UK

Disclosures

KB is an author of references cited in this topic. KB declares that he has no competing interests.

Louis Chang, MD

Assistant Professor of Neurological Surgery

Weill Cornell Medicine

New York

NY

Disclosures

LC declares that he has no competing interests.

  • Differentials

    • Spinal epidural abscess
    • Osteoporotic spinal compression fracture
    • Transverse myelitis
    More Differentials
  • Guidelines

    • Best practice guidelines: spine injury
    • ACR appropriateness criteria: low back pain
    More Guidelines
  • Patient information

    Spinal cord compression: what treatments work?

    Spinal cord compression: what is it?

    More Patient information
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