Cauda equina syndrome the spinal cord: what is it, symptoms, treatment

Bundle of nerve processes located in the lower segment of the spine is called horse tail of the spinal cord because of the external similarity. Cauda equina syndrome is due to compression (pinching) of the nerve fibers. This condition causes a number of unpleasant symptoms. The disease affects the bowels, bladder, genitals, causing pain, numbness and even paralysis of the lower limbs. Often people with this disease require immediate hospitalization and surgery. In many cases, if not in time to take the necessary measures, the consequences can be irreversible and to restore the damaged functions of the organs of the pelvis and musculoskeletal function would be impossible.

The structure of the spinal cord

The spinal cord is located in the cavity of the vertebral column. It starts just below the foramen Magnum and ends in the region of the second lumbar vertebra. It is a channel for fiber nerve paths that create a relationship between spinal and peripheral nerve endings in the brain. Of the segments of the spinal column 31 pairs of nerves coming out from both sides. They are associated with peripheral nerves. The place of attachment of nerve outgrowths called spines.

In the lower part of the spine (i.e., 2 or 3 lumbar vertebra to the tailbone) nerve roots form a horse tail of the spinal cord. It consists of 40 roots, entangling the thread facing the connective tissue. The processes of the nerve is a continuation of the spinal cord. It directly affects touch sensation in the lower part of the body, the process of removing feces and urine, the ability to regulate the work of the sphincter, the muscular-skeletal system.

Cauda equina syndrome is a painful condition that is caused by damage to the nerve roots in the lower region of the vertebral axis.

Symptoms

In accordance on the strength of pinching of the nerve roots may manifest the disease with different symptoms and degrees of pain:

• Unpleasant feelings in the area of compression of the nerves and damaged spinal cord;
• As pain in the lumbar;
• Muscle weakness, numbness or pain in one or both legs;
• "Saddle anesthesia" − that means, what is the numbness in Promega and legs, reminiscent of the seat in the saddle;
• The violation of sexual activity, up to full impotence in men;
• Problems with urination (patient or hard to hold back urine, or, on the contrary, he can't go to the toilet);
• Constipation or fecal incontinence;
• Infringement of a motility of the sphincter;
• Increased flatulence;
• Atrophy reflexes of the lower extremities;
• Blood circulation and metabolism in the lower extremities. This affects the condition of skin, hair and toenails.;
• Complications possible paralysis of the lower extremities.

As a rule, the patient has one of the types of pain syndrome:

• Local – caused due to inflammation of the spine and soft tissues, with a dull pain is chronic. When moving the spine the pain can intensify;
• Radicular pain is sharp, shooting. Occurs when the slopes and curves of the body.

Reasons

Cauda equina syndrome can be the consequence of:

• Injuries of the spine, for example, in a car accident, with severe injuries;
• A strong blow to the lumbar region. In such cases, it may be a hematoma, which will pinch the nerve;
• Diseases of the spine, hernia and tumor;
• Surgery. Surgery can lead to complications and inflammation of the spinal cord;
• Deformation of the intervertebral discs, leading to compression of the nerve roots. Especially prone to this elderly;
• Pathology of innate nature.

Diagnosis

The disease diagnosis is carried out by such methods:

• History (the information the doctor gets from patient interviews);
• A clinical examination. This includes an assessment of the sensitivity, muscle strength and testing of tendon reflexes;
• Magnetic resonance imaging. Due to the electromagnetic waves enables you to see the spine in three dimensions. This kind of study with high precision enables to detect cauda equina syndrome, to localize it and to determine the degree of compression;
• Computed tomography is one of the methods of x-ray studies, whicheffectively identifies pinched nerves and inflammatory processes in the spinal cord. Allows you to see the tissue layers of the spine;
• Myelography is an outpatient procedure studies liquorologic pathways of the spinal cord using contrast rays. The effect is quite unpleasant and painful, as its implementation through the lumbar puncture to be introduced to the puncture with a special substance creates a contrast image. Thanks to the development of more sophisticated and informative methods, myelography is rarely done.

The principle of treatment will completely depend on what contributed to the occurrence of the disease.

Surgical treatment

As a rule, the elimination of cauda equina syndrome occurs due to the operational procedure. Surgical intervention is done openly under General anesthesia. Operation allows efficient release of entrapped nerve roots.

The faster the surgery, the more chance to restore all those affected by the disease functions. If surgery is not performed in time, the patient might result in paralysis of the lower body.

Practice shows that patients with pain in one leg the chances of recovery are greater than if both limbs are sick. Patients with complete numbness in the groin area increases the risk of paralysis of the bladder. In General, the degree of numbness of the perineal area is an important indicator of recovery. If the reason for the nerve compression was the tumor in addition to surgery required radiation therapy and chemotherapy. The sequence of treatment and their combination is selected by the doctor individually in different cases.

Conservative treatment

• Kortikosteroidy ("Budesonide", "Methylprednisolone", "Triamcinolone");
• Anti-inflammatory nonsteroidal means;
• In the presence of bacterial inflammation is prescribed a course of antibiotics.

If conservative treatment does not give the desired results in a short time is assigned to the operation.