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]

Cauda Equina Syndrome: presentation, outcome and predictors with focus on micturition, defecation and sexual dysfunction. Eur Spine J 2017; 26(3): 894-904. [rebelem.com]

Recognition of the syndrome by all groups of clinicians is often delayed as it presents with bladder, bowel, and sexual problems, which are common complaints and have a variety of causes. [bmj.com]

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]

• 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]

  Cauda Equina Syndrome Symptoms & Signs Bowel Incontinence Fecal incontinence can be defined as the unintentional loss of stool (feces) or gas (flatus). [medicinenet.com]

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

• 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]

  In This Article: It is possible for a patient to develop cauda equina syndrome with no history of back pain, or in a patient with a long or recent history of low back pain or sciatica. advertisement The Cauda Equina and Its Function The cauda equina gets [spine-health.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]

• 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]

• 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]

  Sexual dysfunction (i.e. impotence) Physical Exam Saddle Paresthesia Lower extremity weakness, numbness or paresthesias (usually bilateral) Decreased or absent lower extremity reflexes Hypotonia/atrophy of the lower extremities (in chronic presentations) Urinary [rebelem.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]

  – 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 2017) [rebelem.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]

  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]

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]

Even with immediate treatment, some patients may not recover complete function. The best outcomes for cauda equina syndrome occur with earlier treatment. [orthoinfo.aaos.org]

[…] 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]

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]

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]

Radiopaedia has images of cauda-equina cases caused by different etiologies. Cauda Equina Overview AAOS Cauda Equina page [aans.org]

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

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]

Epidemiologic assessments regard lesions to the cauda equina as uncommon, with a prevalence of 1 to 3 per 100,000 subjects. [ncbi.nlm.nih.gov]

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]

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]