How Quickly Cauda Equina Syndrome Can Become a Medical Emergency
Understanding What’s at Stake
Board-certified neurosurgeon, and I want to discuss how quickly kata quinina syndrome can escalate into a medical emergency.
What Is Cauda Equina Syndrome?
The kadocquinina is a Latin term for horse’s tail and it represents the bundle of nerves that leave the bottom of your spinal cord and travel through your spine and your low back. If these nerves get compressed often times from a large herniated disc, it can lead to progressive loss of function including leg weakness, numbness, loss of bowel and bladder control and problems with sexual function. This is called kadocquinus syndrome and these symptoms can be permanent.
A Real-Life Case: How Fast Things Can Change
Let me share with you a story about a young gentleman who was relaxing on his couch when he had a sudden forceful cough and felt a pop in his back. This was immediately followed by severe pain radiating through his low back, buttocks, and down the back of his legs. He also noticed difficulty lifting his feet while walking.
He was concerned by these symptoms and went to the emergency room. The physicians there ordered a CAT scan of the lumbar spine which revealed a large disc herniation at the L45 level which is in the lower lumbar spine. When the emergency physicians examined the patient, he didn’t demonstrate any leg weakness at that time. So he was discharged home with the plan for conservative management of his pain.
However, the patient’s symptoms rapidly worsened and he returned to the emergency room the following day. His leg weakness had progressed to the point where he could no longer walk independently and he hadn’t been able to urinate for the prior 10 hours.
Emergency Diagnosis and Surgery
An MRI of the lumbar spine confirmed the large L45 disc herniation and that it was significantly compressing all of the nerves traveling through that part of the spinal canal. Given the progression of his neurological deficits, including new onset of urinary retention, emergency surgical decompression was arranged.
During surgery, a large disc fragment measuring four centimeters was removed. An MRI after surgery confirmed the herniated disc fragment was gone, and the nerves are no longer pinched.
Recovery and Outcome
Postoperatively, the patient had an excellent recovery. He experienced immediate and complete relief of his lower back and leg pain, resolution of his leg weakness, and return of normal bladder function. He participated in an aggressive rehabilitation program, and was soon walking independently. Within six weeks of surgery, he was able to return to work.
With timely intervention, this patient avoided permanent complications such as paralysis, loss of bowel and bladder control, and sexual dysfunction.
Warning Signs You Should Never Ignore
So, if you or someone you know has back pain along with leg symptoms, sudden weakness, numbness in the inner thighs and groin, or trouble controlling bowel and bladder, get medical help right away. Kadocquinus syndrome is a surgical emergency. The sooner the pressure is taken off the affected nerves, the better the chance of avoiding permanent nerve damage and restoring function.