Cauda equina syndrome (CES) is a rare disorder in which a bundle of nerve roots, called the cauda equina, in the lower portion of the spinal cord are compressed and paralyzed. It is an emergency situation that must be treated as soon as possible to prevent permanent damage. Many conditions and injuries can lead to cauda equina syndrome.
Herniated Disk
The most common cause of cauda equina syndrome is a herniated or slipped disk in the lower, or lumbar, region of the spine. According to Spine University, approximately 1 to 15 percent of all cases of CES are due to a herniated disk. With a herniated disk, the out-of-place disk of the spinal column presses on the nerves of the cauda equina region, resulting in CES.
Injury
Many types of injury or trauma can lead to compression of the nerves in the spinal column. A fracture or dislocation of the lumbar spine, such as through falls or other accidents, can lead to CES. Injury may also cause an unwanted pool or collection of blood around the cauda equina region leading to compression. Cauda equina syndrome may also be caused by penetrating wounds, such as gunshots or stabbings. Certain medical procedures increase the chance of developing CES, for example, poorly placed screws during spinal surgery may compress the nerves in the cauda equina region.
Spinal Stenosis
Spinal stenosis is a condition in which there is a narrowing of the spinal canal. If the narrowing is in the cauda equina region and is severe enough to compress the spinal nerves, cauda equina syndrome may develop. Individuals with spinal stenosis are either born with it, or in most cases, it develops later in life due to degenerative and age-related changes in the spine.
Inflammation
Inflammation of the spine can be due to a variety of conditions and if severe enough, can lead to narrowing of the spinal canal and compression of the spinal nerves. The most common conditions are Paget's disease, ankylosing spondylitis and arachnoiditis. Paget's disease is a bone remodeling disorder leading to weak and misshapen bones which can infringe on spinal nerves. Ankylosing spondylitis is a type of spinal arthritis, and arachnoiditis is inflammation in the arachnoid mater, a membrane around the brain and spinal cord.
Tumor
Tumors, or abnormal growths, in the spinal column can take up space and put pressure on the spinal nerves, leading to cauda equina syndrome. The tumors may be cancerous or non-cancerous, and can originate in the spinal column--called primary neoplasms--or spread from other areas of the body--called metastatic spinal neoplasms. If it spreads, the most common sites of origin are from prostate, breast and lung cancer.
