Wednesday, May 31, 2017

Cauda equina syndrome


What is cauda equina syndrome (CES)?
The cauda equina syndrome is caused by an intraspinal lesion caudal to the conus that injures two or more of the 18 nerve roots constituting the cauda equina within the lumbar spinal canal.

Cauda equina syndrome causes

Symptoms: The cauda equina syndrome is typically associated with marked neurologic disability. The clinical presentation is dominated by bilateral leg weakness in multiple root distributions (L3-S1), and may be associated with perineal sensory symptoms as well as bowel, bladder, and sexual dysfunction due to involvement of the S2-4 spinal nerve roots.

Etiology: Potential etiologies include developmental abnormalities such as neural tube defects, infectious or inflammatory conditions, or mass lesions such as tumors.
The cauda equina syndrome is a rare complication of lumbar spinal stenosis.

In the diagram, I have labelled minimal anatomy on one side and pathology on the other.
Pathology being: Thickened ligamentum flavum, hypertrophied facet (osteophytes) and bulging or herniation of the intervertebral disc!

Also, remember that the nucleus pulposus is a remnant of the notochord (High yield embryology fact for step 1!)

That's all!
A modified version of this diagram will show up in FA 2018 edition, who is excited? :D

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