The cauda equina begins in most people at around L1/L2.
Features of cauda equina syndrome include:
- low back pain
- sciatica
- urinary incontinence/retention
- faecal incontinence/retention
- variable motor/sensory loss
- classically saddle/perianal paraesthesia
Causes of cauda equina are logical when you think about it, you just need to consider what could be there to press on it:
- commonest = large central disc herniation at L4/L5 or L5/S1
- tumours
- trauma
- epidural abscess (consider this one in MRCP questions that mention a 'post op patient')
- post op haematoma (another reason to look out for that 'post-op patient')
- IVC thrombus
- ankylosing spondylitis
- sarcoidosis
Treatment is urgent surgery.
So to the final (and juiciest) battle of the day, surviving sepsis...
