Presented is a case series of 3 patients, all of whom developed neurologic deficits due to cord or cauda equina compression during elective extremity surgery. [ncbi.nlm.nih.gov]

If a patient experiences these symptoms, he or she should present immediately to a Hospital Emergency Department. [hayneslawyers.com]

The Diabetic Foot Matt Solan presents information on the diabetic foot. Diabetes MDT Fred Robinson presents information on the diabetic foot and organisational aspects. Ankle Fractures Jim Barrie presents information on ankle fractures. [boa.ac.uk]

Incontinence at presentation is a poor prognostic sign. [aci.health.nsw.gov.au]

Based upon the above studies, the plaintiff in Anonymous would have had the same outcome if she had been treated emergently at her initial presentation vs. the treatment she actually received — surgery within 24 hours of her initial presentation. [ahcmedia.com]

• Intravenous Drugs

  Past medical history History of intravenous drug use (increases risk of epidural abscess) Previous spinal surgery or arthritis Metabolic bone disease impacts treatment options Osteoporosis; Vit D deficiency; hyperparathyroidism Medications & allergies [oxfordmedicaleducation.com]

• Wound Infection

  Follow-up showed bony union with no further displacement or internal fixation failure, wound infection, delayed healing, or compression of the skin by the plate and screws. [ncbi.nlm.nih.gov]

• Fecal Incontinence

  Incontinence Urinary Retention: due to detrusor muscle weakness Urinary Incontinence Low Back Pain/Sciatica : sciatica may be unilateral or bilateral Variable Lower Extremity Sensory/Motor Dysfunction Lower Extremity Weakness: bilateral or unilateral [mdnxs.com]

  Patient’s may also experience overflow incontinence and present with urinary and/or fecal incontinence (inability to control bowel and/or bladder function). [princetonneurologicalsurgery.com]

  The stool softener or manual evacuation for fecal incontinence may be advised for constipation. For heterotopic ossification stretching exercises, disodium, radiation, and surgical excision are the treatment options. [boneandspine.com]

  incontinence Present later Only urinary retention 14. [slideshare.net]

  He also reports difficulty urinating and some fecal incontinence. Examination reveals generalized lower extremity weakness, saddle paresthesia, hyporeflexia in the lower extremities, and loss of rectal tone. [orthobullets.com]

• Back Pain

  Differentiating between routine back pain and back pain with associated neurological complications is critical because cauda equina must be surgically treated within a short window of opportunity before permanent deficits are likely to occur. [hayneslawyers.com]

  Cauda Equina Syndrome Recovery – Now Possible with Our Help You could say that lower back pain is a normal part of life. Annoying, yes, but it exists. For most people, the pain disappears without treatment. [centerforneurorecovery.com]

  That being said and from a risk management standpoint, it isn’t necessary to order an MRI on all patients with back pain, as the large majority of patients in the ED with back pain do not need further workup. [aliem.com]

  […] urinary symptoms The end-point of a long history of chronic back pain with or without sciatica. [aci.health.nsw.gov.au]

  The five diagnostic categories for spinal disorders (CSAG 1994) Simple back ache (accounts for approx. 95% of back pain). Nerve root pain (accounts for less than 5% of back pain). [rdehospital.nhs.uk]

• Foot Drop

  These deficits can include permanent nerve damage in the legs, foot drop, permanent bowel and/or bladder dysfunction, sexual dysfunction, chronic pain, and other permanent problems. [hayneslawyers.com]

  The feet may not “work right” and may slap on the ground when walking (foot drop). Problems with bowel and bladder function. The patient might find it difficult to start (initiate) urination. [neckandback.com]

  There may be "foot drop" where the foot drags and causes trips and falls. In some cases it may be necessary to use walking aids or a wheelchair. [caudaequina.org]

  Sore Feet: Loss of muscle tone and control over movement of the foot may lead to foot pain. If foot drop is a notable issue, a brace to hold it in position may help. [disabled-world.com]

• Numbness in the Buttocks

  Symptoms which should prompt urgent action include loss of sensation in the lower limbs, numbness in the buttocks / genitial area and difficulties passing urine or with bowel movements. [penningtons.co.uk]

• Screaming

  The maintenance men immediately dragged her away from her location as she screamed in pain and begged to be left alone. She experienced incontinence and pain in many locations of her body. [physiospot.com]

• Urinary Retention

  CONCLUSION: The results indicate that the EA treatment may have longlasting therapeutic effectiveness in the management of neurogenic urinary retention secondary to cauda equina injury. [ncbi.nlm.nih.gov]

  At 12 weeks after operation, the avulsed group demonstrated urinary retention, absence of bladder contractions and external urethral sphincter (EUS) electromyographic (EMG) activation during urodynamic recordings, increased bladder size, and retrograde [jneurosci.org]

  Patients with demonstrated urinary retention are more likely to have CES. Domen et al. found that 75% of patients with CES had urinary retention of more than 500 mL after voiding. [aliem.com]

  The previous guidelines required urinary retention or urinary incontinence. The revised guidelines have a lower threshold and include “difficulty initiating micturition [urinating] or impaired urinary flow”. [stewartslaw.com]

  Cauda Equina Syndrome Symptoms Cauda equina syndrome is roughly categorized into 2 basic types, according to the defining symptom of urinary retention. Complete cauda equina is accompanied by urinary retention while incomplete is not. [verywellhealth.com]

• Urinary Incontinence

  Suprapubic endoscopic suspension of the vesical neck is a popular and effective procedure for the treatment of stress urinary incontinence in women. [ncbi.nlm.nih.gov]

  […] can result in permanent paralysis and urinary incontinence It is very difficult to diagnose CES; in many cases, an accurate diagnosis is often delayed. [dovemed.com]

  Medical conditions, medications, and urinary incontinence. analysis of a population-based survey. Can Fam Physician. 2002; 48 :96–101. [aliem.com]

  […] flow, if untreated this may lead to irreversible urinary retention with overflow urinary incontinence Loss of sensation of rectal fullness, if untreated this may lead to irreversible faecal incontinence Perianal, perineal or genital sensory loss (saddle [medicalprotection.org]

• Overflow Incontinence

  No urinary retention or overflow. Cauda equina syndrome with retention or overflow incontinence. Incontinence at presentation is a poor prognostic sign. [aci.health.nsw.gov.au]

  Patient’s may also experience overflow incontinence and present with urinary and/or fecal incontinence (inability to control bowel and/or bladder function). [princetonneurologicalsurgery.com]

  – up to 92% ( Korse 2017 ) Disruption of autonomic innervation leads to retention and overflow incontinence Bowel dysfunction (constipation and/or incontinence) – up to 74% ( Korse 2017 ) Decreased sensation in the perianal area – up to 93% ( Korse [rebelem.com]

  Overflow incontinence is the problem caused by cauda equina syndrome and is very different than stress incontinence. The bladder cannot send signals to the brain regarding the amount of urine contained in the bladder and the bladder overfills. [neckandback.com]

  Patients have a complete cauda equina syndrome when the bladder becomes paralysed and this leads to painless retention of urine with overflow incontinence. [ncbi.nlm.nih.gov]

• Urinary Stress Incontinence

  Case 1: Bilateral Motor Conduction Studies on the Tibialis Posterior Nerve × Case 2 A 65-yr-old woman underwent perineoplasty because of urinary stress incontinence. Her spinal anesthetic was unremarkable. [anesthesiology.pubs.asahq.org]

Neurologic examination should be routinely performed in the recovery room; and if significant neurologic deficits are seen, investigative workup should not be delayed. [ncbi.nlm.nih.gov]

The authors concluded that ANY new urinary symptoms in the setting of back pain should prompt a workup for CES [5]. [aliem.com]

On the other hand, when acute aortic dissection is suspected, an emergent diagnostic workup should be initiated with ultrasound techniques involving either a transthoracic or transesophageal approach or computerized tomography. [intechopen.com]

OBJECTIVE: To report the therapeutic effectiveness and feasibility of electroacupuncture (EA) treatment in patients with urinary retention which is caused by cauda equina injury and refractory to conventional conservative treatments. [ncbi.nlm.nih.gov]

Fortunately, in most cases, diagnostic and treatment responses in such scenarios are prompt, effective and often able to halt the development of serious complications. [pricebenowitz.com]

Cauda Equina Syndrome Prevention, Symptoms, Treatments and Causes: An article from Emedicinehealth.com discusses this rare spinal cord injury, its treatment and preventative measures. [floridainjuryclaim.com]

Prognosis Cause of cauda equine and promptness of the treatment are two major factors in cauda equine syndrome. Complications are more common if treatment is delayed. [boneandspine.com]

[…] root ) - urinary retention is the most consistent finding; - see urologic management of the spinal cord injured patient : - in spinal cord injuries, the caudal equina may sustain considerable initial trauma & stop functioning, but there may be a good prognosis [wheelessonline.com]

Prognosis The evidence also remains weak for symptom duration before surgery and functional recovery. [oapublishinglondon.com]

[…] is rare, but devastating if symptoms persist Clinical diagnosis is not easy and even in experienced hands is associated with a 43% false positive rate The investigation of choice is magnetic resonance imaging Once urinary retention has occurred the prognosis [bmj.com]

Multiple etiologies can cause the cauda equina syndrome. [ncbi.nlm.nih.gov]

The data encountered in this study show that the main etiology found was disc herniation 69% (13), followed by tumor 16% (3), trauma 10% (2) and vascular 5% (1). Actually these etiologies somehow combine compressive and/or ischemic mechanisms. [scielo.br]

Trial lawyers whose clients suffer from cauda equina syndrome should be well versed in the etiology and treatment of the condition. Victims of automobile accidents, falls, and other trauma may develop cauda equina syndrome. [virginiatrialfirm.com]

CAUDA EQUINA SYNDROME • Etiologies • Disc herniation • Disc fragment migration • Iatrogenic epidural hematoma • Post LP or spinal anesthesia • Postoperatively • Infection • Tumor • Trauma 13. [slideshare.net]

The most likely etiology of her CES was direct damage secondary to the epidural needle puncture. [surgicalneurologyint.com]

Secondarily, this study will serve as a basis for other comparative studies aiming at a better understanding of this condition and its epidemiology. [scielo.br]

[…] surgery for Cauda Equina Syndrome: A Systematic Literature Review. ( 29432394 ) Srikandarajah N....Marson T. 2018 9 Influence of timing of surgery on Cauda equina syndrome: Outcomes at a national spinal centre. ( 29657470 ) Heyes G....Eames N. 2018 10 Epidemiology [malacards.org]

Epidemiological study of cauda equina syndrome. Acta Ortop Bras. [online]. 2013;21(3):159- 62. [Level Of Evidence: 4] ↑ Panos G. Et al. [physio-pedia.com]

CES-I with its more favourable prognosis may become CES-R at a later stage. [22] Epidemiology [ edit ] The nerve roots extending from the lumbar spine are susceptible to compression, leading to CES. [en.wikipedia.org]

Figure 3 : Axial MRI T2 at L3/L4 disc level depicting the exiting L3 nerve root with sacral roots lying posterior in canal Pathophysiology The pathophysiological mechanisms of CES are not completely understood. [oapublishinglondon.com]

The pathophysiology remains unclear but may be related to damage to the nerve roots composing the cauda equina from direct mechanical compression and venous congestion or ischemia. [chiro-trust.org]

Screening and Treatment of Abdominal, Thoracoabdominal and Thoracic Aortic Aneurysms Edited by Reinhart Grundmann Next chapter Anesthetic Management of Aortic Aneurysm By Zsófia Verzár and Sándor Szabados Related Book Etiology, Pathogenesis and Pathophysiology [intechopen.com]

Spinal Cord injury: Definition, Epidemiology, Pathophysiology by Segun T. Dawodu, M.D. [sci.rutgers.edu]

Pathoanatomy and pathophysiology of spinal nerve root compression. Spine. 1984; 9 (1):7–15. doi: 10.1097/00007632-198401000-00004. [ PubMed ] [ CrossRef ] [ Google Scholar ] 38. Rubinstein DJ, Alvarez O, Ghelman B, Marchisello P. [ncbi.nlm.nih.gov]

Use protective pads and pants to prevent leaks. [orthoinfo.aaos.org]

Close surveillance can help prevent lasting problems. (See " FDA Safety Alert: Cauda Equina Syndrome Associated with Use of Small-Bore Catheters in Continuous Spinal Anesthesia.") [rosenfeldinjurylawyers.com]

Causes of CES can include: Trauma A herniated or bulging disc Spinal stenosis Tumors Paget’s disease Ankylosing spondylitis Spondylolisthesis Bone spurs Arthritis of the spine Preventing and treating cauda equina syndrome (CES) The only way to prevent [laserspineinstitute.com]

Drink plenty of fluids and use good personal hygiene to prevent urinary tract infections. Check for waste and clear the bowels with gloved hands. If needed, use glycerin suppositories or enemas. Wear protective pads and pants to prevent leaks. [webmd.com]