Cauda equina syndrome — causes, symptoms and treatment
Pain cauda equina syndrome in the back the man
Horse tail is a bundle of nerves in the fibrous continuation of the spinal cord which in humans terminates at the first lumbar vertebra.
With it comes the innervation of the lower limbs and internal organs in the pelvic region.
Cauda equina syndrome (hereinafter for convenience SKKH) — the defeat of the nerve roots of the beam, as a result of inflammation or mechanical compression, which without immediate surgical intervention may lead to serious disturbances in the functioning of the pelvic organs, to the loss of sensation and even paralysis of the lower extremities.
The manifestation of the syndrome
Initially, there is severe pain localized in the lower back, followed her progress down start to ache the muscles of the buttocks, further the radiation goes on the back of the thighs.
As we can see to ignore these symptoms of cauda equina syndrome just does not work, only if you are taking strong painkillers.
Other manifestations of SKKH include weakness of leg muscles, reducing overall sensitivity in the lower part of the body, numbness of the groin, red-footed Falcon or the sacrum.
If you love to ride horses, it is familiar to you — the loss of sensitivity of the feet due to prolonged compression on the saddle of the horse. Loss of knee and Achilles reflexes can also be associated with SKKH. There are various irregularities in the bowel and bladder, and also in the sexual sphere.
The causes of the disease
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They can be divided into mechanical and inflammatory. It can be:
- herniated disc;
- lumbosacral plexopathy is damage to the anterior branches of the nerve plexus of the spinal cord in the lumbar;
- congenital anomalies;
- narrowing of the lumbar vertebrae;
- tumors of the spinal cord;
- bleeding in the spine;
- infectious diseases.
Signs of the syndrome
Pain when the disease is of two types — local and radicular.
Local is characterized by a strong and deep character, is localized in the place where irritated the body of the vertebra and the surrounding soft tissues.
Radicular occurs when compression of the nerve bundle and it extends along the route of the nerve, characterized by an extremely acute character.
Dysfunction of the pelvic organs can be very different — as urinary retention and incontinence, intestinal constipation or complete fecal incontinence.
The best prognosis the doctors give if the patient is asked not later than two days from onset of symptoms of cauda equina syndrome in humans.
Primary diagnosis is based on interviews with the patient, then the doctor to determine the cause of SKKH and choose an effective treatment method.
To do this, use laboratory tests, use of physical examination (inspection, palpation, and other methods based on the use of a doctor to his senses) examination, computed and magnetic resonance tomography.
This allows you to identify the lesion and to determine are these symptoms a result of cancer or infectious diseases.
Treatment of pathology
As already mentioned, in most cases, in the treatment of cauda equina syndrome use surgery, but the treatment depends on the reasons for the compression.
Bechterew’s disease, which is characterized by inflammation, usually cost conservative methods of treatment — the patient was prescribed corticosteroids and non-steroidal medicines (such as ibuprofen, prioxicam, diclofenac, celebrex, ortophenum).
If the cause of compression are tumor metastases, radiation therapy is also used.
In infectious diseases applied antibiotic therapy based on antibiotics.
Now let’s talk about the surgical treatment.
If the herniated disc is used laminectomy (removal of part of a vertebra) or a discectomy (removal of part of the intervertebral disc).
It is also worth noting that if conservative treatment does not bring effect for 24 hours, then in the case enters surgeons.
The nature of the symptoms, you can build a forecast by SKKH.
For example, patients with pain in both legs have less chance of a full recovery of all functions, than patients with pain in one leg.
If there is complete numbness of the scrotum (perineum) — increased chance of a permanent paralysis of the bladder. Also according to the degree of reduction of numbness in this region can be judged on the progress of recovery.
Restoration of bladder function may be delayed for a couple of years. Postoperative use of drugs aimed at restoration of function of pelvic organs.
Prevention is the proper identification of the symptoms, as most patients with pain in the lower back and legs and muscle weakness, did not receive a diagnosis SKKH.
But if you have problems with sensitivity in the groin area, disturbances in the functioning of the bladder and bowel, you should pay for this patient the utmost attention.
It is also necessary to periodically consult with your doctor about the pain and their relationship with the natural frequency of your shipments.
Remember that between the appearance of pain and numbness and start of treatment is an inverse relationship — the more the time period — the less your chances of a full recovery, and the resulting dysfunction and the paralysis will become permanent and will never allow you to return to normal life.
Take care of yourself and your loved ones!