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Síndrome da cauda equina

  • Overview
  • Theory
  • Diagnosis
  • Management
  • Follow up
  • Resources
Evidence last reviewed: 22 Aug 2026
Topic last updated: 07 Aug 2026

Summary

Definition

History and exam

Key diagnostic factors

  • disfunção vesical
  • fraqueza nos membros inferiores
  • parestesia/anestesia em sela
  • disfunção intestinal
Full details

Other diagnostic factors

  • lombalgia
  • ciática
  • disfunção sexual
Full details

Risk factors

  • hérnia de disco lombar
  • trauma espinhal
  • cirurgia da coluna vertebral
  • abscesso epidural espinhal
  • uso de terapia anticoagulante
  • estenose da coluna vertebral
  • tumor da medula espinhal
  • idade inferior a 50 anos
Full details

Diagnostic tests

1st tests to order

  • RNM da coluna lombar sem contraste intravenoso
  • TC da coluna lombar sem contraste intravenoso
Full details

Tests to consider

  • Mielotomografia da coluna lombar
  • teste urodinâmico
  • exame de toque retal
Full details

Treatment algorithm

ACUTE

síndrome da cauda equina (SCE) confirmada

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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

Todd NV, Dickson RA. Standards of care in cauda equina syndrome. Br J Neurosurg. 2016 Oct;30(5):518-22. Abstract

Finucane LM, Downie A, Mercer C, et al. International framework for red flags for potential serious spinal pathologies. J Orthop Sports Phys Ther. 2020 Jul;50(7):350-72.Full text  Abstract

Expert Panel on Neurological Imaging; Hutchins TA, Peckham M, Shah LM, et al. ACR appropriateness criteria® low back pain: 2021 update. J Am Coll Radiol. 2021 Nov;18(11s):S361-79.Full text  Abstract

Germon T, Ahuja S, Casey ATH, et al. British Association of Spine Surgeons standards of care for cauda equina syndrome. Spine J. 2015 Mar 2;15(3 suppl):S2-4. Abstract

Chau AM, Xu LL, Pelzer NR, et al. Timing of surgical intervention in cauda equina syndrome: a systematic critical review. World Neurosurg. 2014 Mar-Apr;81(3-4):640-50. Abstract

Epstein NE. Review/perspective: operations for cauda equina syndromes - "The sooner the better". 2022 Mar 25;13:100.Full text  Abstract

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.

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