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The spinal cord extends from the brain all the way down to where it ends, in the first lumbar vertebra in the lower back. Nerve roots extend at intervals from the spine to control movement and perception in all areas of the body. A bundle of nerve roots is located at the end of the spinal cord, and forms what is known as the cauda equina, which means "horse tail." Cauda equina syndrome refers to the extreme inflammation or compression of these nerve roots, causing varying symptoms that may incapacitate the patient completely.
Nerve root compression in other areas of the back can cause pain and limited motion, but these are generally not as serious as they are bothersome. Simple measures can be taken to reduce inflammation, and this type of treatment usually solves the problem. Cauda equina syndrome, however, is a serious condition that is considered a medical emergency if its onset is sudden and severe. It can be caused by a well-placed lesion that compresses the nerve bundle, or more commonly by a herniated vertebral disc.
Cauda equina syndrome often presents with symptoms such as severe lower back pain, coupled with urinary or bowel control issues, and possibly sexual dysfunction. Many patients affected by cauda equina syndrome experience such severe pain that they rae unable to walk, or are affected by a lack of strength or sensation in the legs, producing the same result. If the patient experiences weight loss along with the usual symptoms, it may have been caused by cancer that has metastasized. Cauda equina syndrome is quite rare, but it must be considered as a possible diagnosis in patients who present with back pain that is coupled with urinary symptoms. The diagnosis itself is best done by means of a magnetic resonance imaging (MRI) scan or similar procedure.
Although cauda equina syndrome is not seen in patients of any particular race more than another, there does seem to exist a slight predilection in favor of males from 30 to 50 years of age. While potentially debilitating, it is not fatal. A full recovery will depend on the extent of any permanent nerve damage. In general, the more time that has elapsed before treatment is sought, the greater the chance that permanent nerve damage will develop. The only sure treatment for cauda equina syndrome is surgery, which if successful, can lead to an almost immediate recovery.
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