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Cauda equina syndrome

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Cauda equina syndrome (CES) results from compression of the cauda equina below the level of L2. It may result from any space occupying lesion in the spinal canal, often a large central disc protrusion at L4/5. Less commonly, compression may be due to pathology in a higher disc, or to tumour, infection, or trauma.

The syndrome may be differentiated from demyelination of the conus medullaris by the absence of dissociated sensory loss and normal plantars.

CES is a neurosurgical emergency, and delays in diagnosis and treatment may lead to permanent disability. Patients with CES require urgent surgical decompression of the spinal canal.

Reference

  1. The Royal College of Emergency Medicine. Cauda equina syndrome position statement. Feb 2020 [internet publication].

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