Cauda Equina Syndrome

Basics

Description

Compression of lumbar and sacral nerve fibers in cauda equina region:
  • Nerve fibers below conus medullaris
  • Fibers end at L1–L2 interspace

Risk Factors

  • Neoplasm
  • IV drug use
  • Immunocompromised state
  • Trauma

Etiology

  • Herniated disc most common:
    • L4–L5 discs > L5–S1 > L3–L4
    • Most common in fourth and fifth decades of life
  • Mass effect from:
    • Myeloma, lymphoma, sarcoma, meningioma, neurofibroma, hematoma
    • Spine metastases (breast, lung, prostate, thyroid, renal)
    • Epidural abscess (especially in IV drug users)
  • Blunt trauma
  • Penetrating trauma
  • Spinal anesthesia
  • Other rare causes:
    • Congenital anomalies, multiple sclerosis, spinal AVMs, neurosarcoidosis, IVC thrombosis

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