Sagittal Spine MRI. Post-surgical lumbar spine edema resulting in cauda equina compression and asymmetric flaccid paralysis. Abnormality highlighted.
Cauda Equina Syndrome
Compression of the nerve roots inferior to the spinal cord causes asymmetric lower extremity weakness/paralysis, bowel/bladder incontinence, loss of lower extremity sensation or "saddle" distribution sensory loss (buttocks, perineum, posterior-superior thighs), and gait imbalance. Reflexes are absent because this is a lower motor neuron pattern of injury.
Common Causes of Cauda Equina Syndrome:
- Congenital (Tethered cord, Spina Bifida)
- Compressive (Disc Herniation, Trauma, Tumor, Hematoma, Abscess, Post-surgical)
- Vascular (Arteriovenous malformation, Aortic dissection)
- Radiculitis: Auto-Immune/Infectious(& Post-Infectious)/Neoplastic