The Cauda Equina and Its Function
The cauda equina is responsible for sensory and motor innervation to the pelvis and lower limbs , as well as bowel and bladder function. If the cauda equina is damaged by inflammation or compression in the low back, symptoms may be severe and may develop quickly.
What is cauda equina and filum terminale?
The fibrous extension of the cord, the filum terminale, is a nonneural element that extends down to the coccyx. The cauda equina (CE) is a bundle of intradural nerve roots at the end of the spinal cord , in the subarachnoid space distal to the conus medullaris.
What is the function of the cauda equina Filum terminale?
This strand stabilizes the spinal cord by connecting the conus medullaris to the coccyx (end of the spine).
What is the function of filum terminale?
The filum terminale (FT) is a fibrous band that extends from the conus medullaris to the periosteum of the coccyx, and its functions are to fixate, stabilize, and buffer the distal spinal cord from normal and abnormal cephalic and caudal traction .
What does the cauda equina supply?
The cauda equina occupies the lumbar cistern, a subarachnoid space inferior to the conus medullaris. The nerves that compose the cauda equina innervate the pelvic organs and lower limbs to include motor innervation of the hips, knees, ankles, feet, internal anal sphincter and external anal sphincter.
What are the first signs of cauda equina?
- Lower limb weakness and intermittent changes in sensation, such as numbness.
- “Saddle anesthesia” – loss or diminished sensation in areas where a person would sit on a saddle.
- Urinary and/or bowel problems, such as retention or incontinence.
What happens if cauda equina is not treated?
If patients with cauda equina syndrome do not seek immediate treatment to relieve the pressure, it can result in permanent paralysis , impaired bladder and/or bowel control, loss of sexual sensation, and other problems.
What is the best treatment for cauda equina syndrome?
Cauda equina syndrome is best treated with decompression by a lumbar laminectomy , but a lumbar microdiscectomy may be used given a patient’s unique situation. The patient will likely be kept in the hospital for a few days following the surgery to monitor recovery of motor and sensory function.
How does cauda equina start?
Cauda equina syndrome can present in 2 ways: acute onset , where the symptoms and signs occur rapidly, and insidious onset, where the condition begins as lower back pain and slowly progresses to bowel and urinary incontinence. Cauda equina syndrome is most commonly caused by compression from a lumbar herniated disc.
Can cauda equina be seen on MRI?
Due to its ability to depict the soft tissues, MRI generally has been the favored imaging study for assisting the physician in the diagnosis of cauda equina syndrome. Urgent MRI is recommended for all patients who have new-onset urinary symptoms with associated back pain or sciatica.
What does equina mean?
The cauda equina is a descriptive Latin term referring to the bundle of nerve roots from the lumbar and sacral levels that branch off the bottom of the spinal cord like a “horse’s tail.”
What does Filum mean?
Medical Definition of filum
: a filamentous structure : filament .
What is called filum terminale?
The filum terminale is the nonfunctional continuation of the end of the spinal cord . It usually consists of fibrous tissue without functional nervous tissue.
Can you live with cauda equina?
Many, including celebrities like Duncan James, have experienced cauda equina syndrome and there are people out there who can support you to live your life as you want following your injury . It may be a challenge, but the people I have met along the way – through CESA and elsewhere – have been a real source of support.
At what level does cauda equina start?
The cauda equina is a group of nerves and nerve roots stemming from the distal end of the spinal cord, typically levels L1-L5 and contains axons of nerves that give both motor and sensory innervation to the legs, bladder, anus, and perineum.
What is the difference between cauda equina and spinal cord compression?
Spinal cord compression and Cauda Equina Syndrome have similar symptoms, including back pain and weakness or paralysis of the lower limbs. This means the relatively rare Cauda Equina Syndrome is often misdiagnosed as spinal cord compression, resulting in the right treatment often not being given in time.
