Clinical focus: a look at cauda equina

What is it? 

Pressure on the bottom of the spinal cord due to a back injury causing compression of the cord. The pressure on the nerves stops the nerves from working properly, and if not treated quickly then it may cause permanent nerve damage. 

As well as being caused by trauma, such as a slipped disc, it can also have a non-traumatic cause, such as a primary spinal tumour or cancer that has spread to the spine. 

What does it look like? 

In addition to the usual symptoms of a back problem, e.g. lower back pain, sciatica etc., red flags for cauda equina are any of the following:

• sphincter, bladder or bowel disturbance including urinary retention
• gait disturbance
• numbness around the anal and sacral area
• bilateral lower limb weakness. 

What should I do about it? 

Convey the person to the nearest suitable hospital for further assessment and management.

Published 24th November 2014