yogabook / pathologie / cauda equina-syndrome
Contents
cauda equina-syndrome
efinition of
Compression of the cauda equina, often together with compression of the conus medullaris (cone-shaped end of the spinal cord S3-S5), is an indication for immediate surgery (within 6 hours of the onset of symptoms (!), irreversible deficits may occur after more than 12 or 24 hours.
ICD G83.4
Cause
- Severe dorso-medial discprolapse, usually the disc hernia has existed for a longer period of time with less severe symptoms
- Spinal metastases
- Pressure atrophy of the nerves after operations such as surgical stiffening
- Vertebral fracture
Diagnosis
- Neurological tests
- MRI
- CT
- Absence of patellar tendon reflex (L4) and/or absence of Achilles tendon reflex (S1)
- Reduced tone of the Auns sphincter (rectal digital examination)
- Possible failure or weakening of the patellar tendon reflex or Achilles tendon reflex
- Tests and signs: crossed Lasegue
Symptoms
- bilateral or alternating sciatica-like pain
- Highlight: Breeches anesthesia/hypesthesia (on the inside of the leg), often also asymmetrically pronounced
- Highlight: rectal and bladder incontinence/disorders, also – paralysis
- Erectile dysfunction
- Radicular(nerve root) pain alternating between the sides
- Motor deficits in the leg or foot (flaccid paralysis), especially weakness of the foot lifter
- Sensory disorders usually occur well after motor disorders
- Sweat secretion is maintained
- Possible tension pain in the filled bladder, which intensifies when coughing/sneezing
Complications
- Pressure atrophy of the nerves
- Failure of internal organs
Therapy
- OP
DD
- severe polyneuropathies