The cauda syndrome (also called cauda syndrome) describes a pinching of the nerves in the area of the cauda equina. It is often associated with a severe herniated disc and requires immediate action when the typical symptoms appear in order to decompress the pinched nerves and avert worse consequences such as paralysis.
What is Kauda Syndrome?
Most people with cauda syndrome initially experience non-specific back pain or sensory disturbances in the lower back. Symptoms of paralysis of the arms and legs are also common. See AbbreviationFinder for abbreviations related to Kauda Syndrome.
The cauda syndrome refers to the symptoms and clinical pictures that are associated with a contusion of the sensitive nerves in the lower part of the spinal cord, the so-called “cauda equina”.
This leads to pain in the lumbar spine, which radiates into one leg or even both legs and into the lower leg, and severe bladder pain, which increases when body pressure increases (e.g. when sneezing or coughing). In caudal syndrome, so-called breeches anesthesia is recorded, which means that the anal area and the area of the inner thighs become numb.
Impotence is another symptom of Kauda’s syndrome. Control of bowel and bladder emptying is often lost, and rectal examination reveals a relaxed sphincter. The legs become weak, in many cases a real drop in the foot is found, and the mechanical reflexes of the leg (e.g. hamstring reflex) no longer work properly or not at all.
Cauda syndrome is always triggered by damage to the sensitive nerves in the lower spine caused by a (usually long-lasting) contusion.
The contusion of the nerves that leads to cauda syndrome can in turn be caused by various triggers. On the one hand, it can be a particularly severe herniated disc, on the other hand, metastases in the area of the lower spine can be responsible for the damage.
A bone injury, a pushing out of individual vertebrae, which then press on the nerve fiber complex, or a vertebral fracture are also possible causes. Tragically, however, in some cases during surgical interventions, the typical crushing of the nerve fibers occurs, which then causes cauda syndrome.
Symptoms, Ailments & Signs
The course of the Kauda syndrome is expressed by a series of symptoms and complaints that appear suddenly and lead to chronic disorders within a short time. Most people initially experience non-specific back pain or sensory disturbances in the lower back area. Symptoms of paralysis of the arms and legs are also common. If the contusion is not treated immediately, permanent paralysis can set in.
Pinching nerves can also cause loss of bladder and bowel control. The patients usually also develop a chronic pain syndrome, which considerably limits their quality of life. The Kauda syndrome usually sets in acutely. It is often preceded by a severe herniated disc, bone injury, or metastases.
The syndrome cannot be recognized externally. However, as the disease progresses, it can lead to poor posture, restricted mobility and other symptoms that are externally visible. If cauda syndrome occurs during an operation, the symptoms appear suddenly and quickly increase in intensity. If treatment is not given or is given too late, the nerves will be permanently damaged. This can lead to incontinence, circulatory disorders and, in the worst case, paraplegia.
Diagnosis & History
Kauda ‘s syndrome is one of the most dangerous diseases that can occur in humans and must be treated immediately. If the crushed nerve fibers are not surgically decompressed within the first six hours of the onset of the typical symptoms, the symptoms (e.g. paralysis and sensory disturbances in the legs and loss of control over the bladder and bowel) usually become chronic and can only in rare exceptional cases partially regress.
Therefore, the diagnosis of Kauda’s syndrome plays a central role. As soon as signs of cauda syndrome appear, the diagnosis must be made immediately. Neurological examinations (e.g. checking the Achilles tendon or patellar tendon reflex, checking the sensitivity in the affected regions and the sphincter) in connection with imaging methods such as computed tomography or MRI are possible for the diagnosis. Once diagnosed, Kauda’s syndrome requires immediate treatment.
In most cases, cauda syndrome occurs in connection with a herniated disc. This leads to considerable limitations in the movement and in the everyday life of the patient. If immediate treatment is not provided, the nerves may be irreversibly damaged, leading to significant limitations in the patient’s life.
Pinching nerves usually leads to paralysis or various sensory disorders. Those affected suffer from severe back pain and severe paralysis in the legs. It is not uncommon for patients to be dependent on a wheelchair and also on the help of other people in their everyday life. The paralysis can also lead to significant psychological problems or depression.
It is not uncommon for those affected to struggle with suicidal thoughts. The quality of life is significantly reduced by the Kauda syndrome. As a rule, treatment must begin a few hours after the first appearance of the cauda syndrome. It is possible that nerves cannot be saved.
If the treatment is initiated with a delay, irreversible damage usually occurs, so that the patients suffer from disabilities for the rest of their lives. However, life expectancy is not reduced by Kauda syndrome.
When should you go to the doctor?
Sudden pain in the lower back area is considered a warning signal from the body. They must be examined and treated immediately so that there is no increase in symptoms and no lifelong impairments develop. Abnormalities in the lumbar spine are considered alarming and should be examined by a specialist. If the pain extends to the affected person’s anal area, a doctor’s visit is required immediately.
In the case of paralysis, limitations in the usual mobility or a loss of the usual level of physical performance, a doctor is required for further examinations and the search for the cause of the symptoms. The affected person should take it easy immediately after the onset of the pain and only move slowly until medical attention is sought. Sensitivity disorders, numbness or hypersensitivity to touching the lower back should be examined and treated. If your back is bruised as a result of an accident, fall or physical assault, you must see a doctor.
The damaged region is examined in imaging procedures so that the necessary steps for medical care can be initiated. If there is also a disturbance of potency in men, this symptom is alarming. A doctor must be consulted as soon as possible. If symptoms occur when emptying the intestines or the kidneys, a doctor’s visit is also necessary.
Treatment & Therapy
Once a caudal syndrome has been diagnosed, neurosurgery is indicated as soon as possible to decompress the nerve fibers affected by the crush.
This procedure should be performed within the first six hours of the onset of one or more symptoms of cauda syndrome to avoid permanent nerve damage. If the intervention is too late and the contusion has already irreparably damaged the nerves, the symptoms of cauda syndrome do not regress but remain chronic.
Those affected then suffer from symptoms of paralysis and numbness and usually lose control of the bladder and intestines. Only in very few cases can the stimulation of the damaged nerves lead to regaining partial control over the affected areas of the body.
Outlook & Forecast
The prognosis of Kauda’s syndrome depends on the triggering disorder. If the pinched nerves can be relieved by correcting the vertebrae with a few professional steps, the symptoms are usually alleviated within a short time. A broken, bruised or sprained bone also has a good chance of recovery. It takes some time to rest and rest and monitor the regeneration process before you see an improvement.
The course of the disease and the prognosis worsen when metastases have formed in the organism. If these are the causal reason for the symptoms, cancer therapy must be carried out. The prospect of a cure depends on the stage of the cancer. In severe cases and with advanced development, the patient is threatened with premature death.
In the case of a particularly severe herniated disc, the prognosis is also worse. Surgery can improve health. Surgery is associated with various risks and side effects. In addition, various complications can occur in the further course of healing, which have an impact on the prognosis of the Kauda syndrome. There is a possibility of a chronic course of the disease. This leads to a significant reduction in the quality of life and the ability to cope with everyday life and can trigger psychological complications.
There is currently no known effective prevention of Kauda’s syndrome. However, it certainly makes sense to be physically active, not to weigh too much, and to have a strong core musculature to minimize the chance of suffering a herniated disc. However, it is and remains central to seek immediate medical help the first time symptoms of Kauda’s syndrome appear – and thus at least prevent the symptoms of Kauda’s syndrome from becoming chronic.
In most cases, the aftercare measures for Kauda’s syndrome are very limited. First and foremost, the person concerned should see a doctor very early on, so that no further complications or symptoms occur. Early detection of the disease is the only way to prevent the symptoms from getting worse.
Ideally, those affected have already consulted a doctor at the first sign of Kauda’s syndrome. Self-healing cannot occur with this disease. In the case of this disease, an immediate surgical intervention must usually take place so that the affected person does not become permanently paralyzed. After such an operation, strenuous, stressful or physical activities should be avoided at all costs.
Many patients are also dependent on the help and support of their own families in their everyday lives, whereby intensive and loving conversations can also have a positive effect on the further course and also on the condition of the person concerned. Physiotherapy measures are also necessary, although many of the exercises from such therapy can also be repeated at home. Most of the time, Kauda’s syndrome does not limit the life expectancy of the sufferer.
You can do that yourself
Immediate action is required when cauda syndrome occurs. The affected person should consult a doctor at the first symptoms and have the symptoms clarified. If the contusion is treated early enough, the spine can be loaded again relatively quickly after the operation. In the first two to three weeks, however, rest is initially indicated. Physical work, especially work that could strain the intervertebral discs, should be strictly avoided.
In addition to the aftercare, the causes of the bruise must be determined. A tumor is often the cause that needs to be diagnosed and treated. If the cauda syndrome is based on chronic poor posture, therapeutic measures are indicated. In most cases, the workload also has to be reduced. If the contusion is treated too late, permanent nerve damage has usually already occurred. The resulting paralysis must be treated with physiotherapy. The most important self-help measure is to reduce the everyday limitations through aids and a disabled-friendly facility.
Therapeutic counseling helps the person concerned to accept the new life situation. It makes sense to visit a self-help group, because talking to other people affected makes dealing with a disability much easier.