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Terms in this set (9)
What is the cauda equina?
The bundle of nerve roots below the conus medullaris
What is cauda equina syndrome?
Extreme nerve compression of the cauda equina
What kind of symptoms does cauda equina syndrome cause?
-Low back pain
-Pain in one leg (unilateral) or both legs (bilateral) that starts in the buttocks and travels down the back of the thighs and legs (sciatica)
-Numbness in the groin or area of contact if sitting on a saddle (perineal or saddle paresthesia)
-Bowel and bladder disturbances
-Lower extremity muscle weakness and loss of sensations
-Reduced or absent lower extremity reflexes
-Diminished or absent anal tone
Is treatment necessary for cauda equina syndrome?
Yes; it is a surgical emergency. If left untreated can cause irreversible loss of bowel and bladder tone and permanent paralysis of legs
What causes cauda equina syndrome?
- Spinal tumors (neoplasms), such as metastatic tumors, meningiomas, schwannomas, and ependymomas
-Inflammatory conditions: Paget's disease and ankylosing spondylitis
-Infectious conditions: spinal epidural abscess
-Accidental causes by medical intervention-lumbar puncture (iatrogenic causes)
What should the physical exam include with cauda equina syndrome?
-Testing muscle strength of the lower extremities
-Evaluating sensation to touch and pain, especially around the groin (perineum)
-Checking the lower extremity reflexes
-Evaluating rectal tone, sensation, and reflex.
What imaging studies should be considered with cauda equina syndrome?
-Plain x-ray films of the lower back to assess for evidence of trauma or severe arthritis (degenerative changes).
-MRI with and without contrast provides a detailed look at tumors, infection, intervertebral disks, and nerve roots. This determines if the nerves are being compressed, to what degree, and by what structures.
What kind of surgery is indicated for cauda equina syndrome?
Surgical decompression of the spine
Is the surgery different if the cause is herniated disk?
Yes; a laminectomy and/or diskectomy may be performed to make room for surgical decompression
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