HF 8192

Cauda Equina Syndrome (CES)

Cauda equina is the collection of nerves at the end of the spinal cord. This is a normal part of the human body.

Cauda Equina Syndrome

Cauda equina syndrome (CES) is a medical emergency. It is caused by compression or “squeezing” of the cauda equina in your low back and sacrum.



CES can be caused by:

  • Ruptured or herniated disc in the lumbar spine (low-back). This is the most common reason.

  • Spinal stenosis or when the spinal canal which surrounds the nerves narrows.

  • Spinal swelling or infection.

  • Tumor or lesion on the spine.

  • Traumatic injury to the spine. This kind of trauma could be caused by a car-crash, stab-wound, or gunshot.

  • Spinal birth defects.


A patient with cauda equina syndrome may have a sudden onset of one or all of the symptoms below.

  • Constipation: not able to have bowel movement

  • Urinary retention: not able to empty bladder

  • Fecal or urinary incontinence: not able to control the bladder or bowel

  • Weakness in the lower body parts

  • Numbness, tingling, pain or even loss of feeling in the legs or low-back

  • Saddle-anesthesia: loosing feeling in the areas of your body which you would use to sit in a saddle


Even after treatment, patients may face life-long symptoms.

Patients may not regain complete bladder function. They may need help emptying the bladder with methods such as intermittent self-catheterization.

Patients may also need help emptying their bowel. Methods may include laxatives or bulking agents, and/or manual evacuation.

Patients may also have changes in sexual function.

The type of treatment depends on the cause of CES. Patients should seek treatment within 48 hours of new symptoms to reduce permanent damage.

Treatments may include:

  • Corticosteroids

  • Antibiotics

  • Spinal decompression surgery

    • Discectomy: taking out part of the vertebral disc

    • Decompressive laminectomy: enlarging the spinal canal to relieve pressure on spinal cord or nerves

  • Tumor resection or removal

  • Radiation and/or chemotherapy


Patients may need to seek help from:

  • Continence physiotherapy will teach you how to manage your bladder and bowel.

  • Occupational therapy will teach you how to complete daily activities(dressing, bathing, eating).

  • Physical therapy will help build strength, balance, and overall body movement.

  • Support groups

If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.