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Cauda equina syndrome

MedGen UID:
98229
•Concept ID:
C0392548
•
Disease or Syndrome
Synonyms: Cauda Equina Syndrome; Cauda Equina Syndromes
SNOMED CT: Cauda equina syndrome (192970008)
 
Monarch Initiative: MONDO:0005693

Definition

A rare neurologic disorder caused by impingement of the nerve roots of the cauda equina secondary to disc herniation, spinal stenosis, vertebral fracture, neoplasm or infection. Clinical signs may include bladder or bowel dysfunction, paresthesia and weakness of the lower extremities. The clinical course rapidly deteriorates and necessitates emergent surgical decompression to minimize risk of incontinence, sexual dysfunction and permanent paralysis. [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVCauda equina syndrome

Professional guidelines

PubMed

Lumbar Disc Herniation: Diagnosis and Management.
Zhang AS, Xu A, Ansari K, Hardacker K, Anderson G, Alsoof D, Daniels AH
Am J Med 2023 Jul;136(7):645-651. Epub 2023 Apr 17 doi: 10.1016/j.amjmed.2023.03.024. PMID: 37072094
Muscle Weakness in Adults: Evaluation and Differential Diagnosis.
Larson ST, Wilbur J
Am Fam Physician 2020 Jan 15;101(2):95-108. PMID: 31939642
The current management of lumbar spondylolisthesis.
Alfieri A, Gazzeri R, Prell J, Röllinghoff M
J Neurosurg Sci 2013 Jun;57(2):103-13. PMID: 23676859

Curated

UK NICE Clinical guideline (CG148), Urinary incontinence in neurological disease: assessment and management, 2023

Recent clinical studies

Etiology

Evaluation and Management of Cauda Equina Syndrome.
Kuris EO, McDonald CL, Palumbo MA, Daniels AH
Am J Med 2021 Dec;134(12):1483-1489. Epub 2021 Aug 30 doi: 10.1016/j.amjmed.2021.07.021. PMID: 34473966
Manipulative Therapies: What Works.
Smith MS, Olivas J, Smith K
Am Fam Physician 2019 Feb 15;99(4):248-252. PMID: 30763049
Assessment and management of cauda equina syndrome.
Greenhalgh S, Finucane L, Mercer C, Selfe J
Musculoskelet Sci Pract 2018 Oct;37:69-74. Epub 2018 Jun 7 doi: 10.1016/j.msksp.2018.06.002. PMID: 29935940
Diagnostic triage for low back pain: a practical approach for primary care.
Bardin LD, King P, Maher CG
Med J Aust 2017 Apr 3;206(6):268-273. doi: 10.5694/mja16.00828. PMID: 28359011
Evaluation and treatment of acute low back pain.
Kinkade S
Am Fam Physician 2007 Apr 15;75(8):1181-8. PMID: 17477101

Diagnosis

Lumbar Disc Herniation: Diagnosis and Management.
Zhang AS, Xu A, Ansari K, Hardacker K, Anderson G, Alsoof D, Daniels AH
Am J Med 2023 Jul;136(7):645-651. Epub 2023 Apr 17 doi: 10.1016/j.amjmed.2023.03.024. PMID: 37072094
Cauda Equina Syndrome.
Bulloch L, Thompson K, Spector L
Orthop Clin North Am 2022 Apr;53(2):247-254. Epub 2022 Mar 8 doi: 10.1016/j.ocl.2021.11.010. PMID: 35365269
Cauda equina syndrome-a practical guide to definition and classification.
Lavy C, Marks P, Dangas K, Todd N
Int Orthop 2022 Feb;46(2):165-169. Epub 2021 Dec 4 doi: 10.1007/s00264-021-05273-1. PMID: 34862914Free PMC Article
Evaluation and Management of Cauda Equina Syndrome.
Kuris EO, McDonald CL, Palumbo MA, Daniels AH
Am J Med 2021 Dec;134(12):1483-1489. Epub 2021 Aug 30 doi: 10.1016/j.amjmed.2021.07.021. PMID: 34473966
A practical review of functional neurological disorder (FND) for the general physician.
Bennett K, Diamond C, Hoeritzauer I, Gardiner P, McWhirter L, Carson A, Stone J
Clin Med (Lond) 2021 Jan;21(1):28-36. doi: 10.7861/clinmed.2020-0987. PMID: 33479065Free PMC Article

Therapy

Conservative Treatment for Giant Lumbar Disc Herniation: Clinical Study in 409 Cases.
Ma Z, Yu P, Jiang H, Li X, Qian X, Yu Z, Zhu Y, Liu J
Pain Physician 2021 Aug;24(5):E639-E648. PMID: 34323452
Cauda equina syndrome.
Barraclough K
BMJ 2021 Jan 12;372:n32. doi: 10.1136/bmj.n32. PMID: 33436390
Manipulative Therapies: What Works.
Smith MS, Olivas J, Smith K
Am Fam Physician 2019 Feb 15;99(4):248-252. PMID: 30763049
Mechanical Low Back Pain.
Will JS, Bury DC, Miller JA
Am Fam Physician 2018 Oct 1;98(7):421-428. PMID: 30252425
Evaluation and treatment of acute low back pain.
Kinkade S
Am Fam Physician 2007 Apr 15;75(8):1181-8. PMID: 17477101

Prognosis

Cauda equina syndrome.
Hoeritzauer I, Paterson M, Jamjoom AAB, Srikandarajah N, Soleiman H, Poon MTC, Copley PC, Graves C, MacKay S, Duong C, Leung AHC, Eames N, Statham PFX, Darwish S, Sell PJ, Thorpe P, Shekhar H, Roy H, Woodfield J; Understanding Cauda Equina Syndrome (UCES) Study Collaborators, and the British Neurosurgical Trainee Research Collaborative
Bone Joint J 2023 Sep 1;105-B(9):1007-1012. doi: 10.1302/0301-620X.105B9.BJJ-2022-1343.R1. PMID: 37652459
Cauda Equina Syndrome.
Bulloch L, Thompson K, Spector L
Orthop Clin North Am 2022 Apr;53(2):247-254. Epub 2022 Mar 8 doi: 10.1016/j.ocl.2021.11.010. PMID: 35365269
Cauda equina syndrome-a practical guide to definition and classification.
Lavy C, Marks P, Dangas K, Todd N
Int Orthop 2022 Feb;46(2):165-169. Epub 2021 Dec 4 doi: 10.1007/s00264-021-05273-1. PMID: 34862914Free PMC Article
Mechanical Low Back Pain.
Will JS, Bury DC, Miller JA
Am Fam Physician 2018 Oct 1;98(7):421-428. PMID: 30252425
Evaluation and treatment of acute low back pain.
Kinkade S
Am Fam Physician 2007 Apr 15;75(8):1181-8. PMID: 17477101

Clinical prediction guides

Cauda equina syndrome.
Hoeritzauer I, Paterson M, Jamjoom AAB, Srikandarajah N, Soleiman H, Poon MTC, Copley PC, Graves C, MacKay S, Duong C, Leung AHC, Eames N, Statham PFX, Darwish S, Sell PJ, Thorpe P, Shekhar H, Roy H, Woodfield J; Understanding Cauda Equina Syndrome (UCES) Study Collaborators, and the British Neurosurgical Trainee Research Collaborative
Bone Joint J 2023 Sep 1;105-B(9):1007-1012. doi: 10.1302/0301-620X.105B9.BJJ-2022-1343.R1. PMID: 37652459
Cauda Equina Syndrome.
Bulloch L, Thompson K, Spector L
Orthop Clin North Am 2022 Apr;53(2):247-254. Epub 2022 Mar 8 doi: 10.1016/j.ocl.2021.11.010. PMID: 35365269
Conservative Treatment for Giant Lumbar Disc Herniation: Clinical Study in 409 Cases.
Ma Z, Yu P, Jiang H, Li X, Qian X, Yu Z, Zhu Y, Liu J
Pain Physician 2021 Aug;24(5):E639-E648. PMID: 34323452
A randomized controlled study for the treatment of middle-aged and old-aged lumbar disc herniation by Shis spine balance manipulation combined with bone and muscle guidance.
Xu J, Ding X, Wu J, Zhou X, Jin K, Yan M, Ma J, Wu X, Ye J, Mo W
Medicine (Baltimore) 2020 Dec 18;99(51):e23812. doi: 10.1097/MD.0000000000023812. PMID: 33371159Free PMC Article
Red flags presented in current low back pain guidelines: a review.
Verhagen AP, Downie A, Popal N, Maher C, Koes BW
Eur Spine J 2016 Sep;25(9):2788-802. Epub 2016 Jul 4 doi: 10.1007/s00586-016-4684-0. PMID: 27376890

Recent systematic reviews

Definition and surgical timing in cauda equina syndrome-An updated systematic review.
Mustafa MA, Richardson GE, Gillespie CS, Islim AI, Wilby M, Clark S, Srikandarajah N
PLoS One 2023;18(5):e0285006. Epub 2023 May 4 doi: 10.1371/journal.pone.0285006. PMID: 37141301Free PMC Article
Intradural Cauda Equina Metastases: A Systematic Review of Clinico-radiological Features, Management, and Treatment Outcomes.
Palmisciano P, Zaidi SE, Shlobin NA, Sagoo NS, Bin Alamer O, Scalia G, Ferini G, Umana GE, Aoun SG, Haider AS
Anticancer Res 2022 Apr;42(4):1661-1669. doi: 10.21873/anticanres.15643. PMID: 35346985
Low Back Pain in the Emergency Department: Prevalence of Serious Spinal Pathologies and Diagnostic Accuracy of Red Flags.
Galliker G, Scherer DE, Trippolini MA, Rasmussen-Barr E, LoMartire R, Wertli MM
Am J Med 2020 Jan;133(1):60-72.e14. Epub 2019 Jul 3 doi: 10.1016/j.amjmed.2019.06.005. PMID: 31278933
Definitions of traumatic conus medullaris and cauda equina syndrome: a systematic literature review.
Brouwers E, van de Meent H, Curt A, Starremans B, Hosman A, Bartels R
Spinal Cord 2017 Oct;55(10):886-890. Epub 2017 May 23 doi: 10.1038/sc.2017.54. PMID: 28534496
Timing of surgical intervention in cauda equina syndrome: a systematic critical review.
Chau AM, Xu LL, Pelzer NR, Gragnaniello C
World Neurosurg 2014 Mar-Apr;81(3-4):640-50. Epub 2013 Nov 13 doi: 10.1016/j.wneu.2013.11.007. PMID: 24240024

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    Clinical resources

    Practice guidelines

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    Curated

    • NICE, 2023
      UK NICE Clinical guideline (CG148), Urinary incontinence in neurological disease: assessment and management, 2023

    Reviews

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      Related information in PubMed Central Links
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