Cauda Equina Syndrome

Anatomy:

… subarachnoid space is prolonged in a dural-arachnoid sheath around each dorsal and ventral root, roughly to level of union of roots;

… because the cord is shorter than vertebral column, nerves slope inferiorly from their levels of origin to appropriate intervertebral foramina, and the angle becomes more acute from above downward;

… below inferior end of cord, dural-arachnoid sac contains leash of nerve roots and the filum terminale;

… this complex constitutes the cauda equina;

Cauda Equina Syndrome:

… urinary retention is the most consistent finding;

… in spinal cord injuries, the caudal equina may sustain considerable initial trauma & stop functioning, but there may be a good prognosis for partial cauda injuries;

… in any potential cauda equina syndrome it is important to examine for saddle anesthesia, rectal tone, bulbocaverosus reflex, and sacral sparing;