12th August 2024

Cauda equina syndrome (CES)

CES is a neurosurgical emergency caused by canal stenosis compressing 2 or more of the 18 nerve roots making up the cauda equina. Though involving the canal, it is not a myelopathy, as it occurs below the conus medullaris. The most common causes are degenerative spinal disease, abscesses, tumours, or inflammatory conditions. It presents with symptoms which can include back or leg pain, sensory impairment, weakness, sphincter and sexual dysfunction, and saddle anaesthesia. Diagnosis is with MRI, and treatment is with urgent surgical decompression.