Overview
Cauda equina syndrome (CES) is a surgical emergency characterized by compression of the nerve roots in the lumbar sac of the spinal canal 1. This compression can lead to significant neurological deficits 1.Diagnosis
Key diagnostic features include bilateral sciatica, saddle anesthesia, bowel or bladder dysfunction (incontinence or retention), and motor/sensory deficits in the lower extremities 1.
Magnetic resonance imaging (MRI) is the preferred imaging modality to identify the level and cause of compression 1.Management
Urgent surgical decompression is the cornerstone of management to prevent permanent neurological damage 1.
The goal of surgery is to relieve pressure on the nerve roots 1.Key Recommendations
Urgent surgical decompression is recommended for patients with cauda equina syndrome 1. (Evidence: Strong)
Magnetic resonance imaging (MRI) is the diagnostic test of choice for suspected cauda equina syndrome 1. (Evidence: Strong)References
1 Sun CR, Liu MY, Ni QH, Cai F, Tang F, Yu ZY et al.. Clinical Guidelines on Compression Therapy in Venous Diseases. Annals of vascular surgery 2025. link