Cauda Equina and Conus Medullaris Syndromes Questions & Answers

Updated: Jun 14, 2018
  • Author: Segun Toyin Dawodu, JD, MD, MS, MBA, LLM, FAAPMR, FAANEM; Chief Editor: Nicholas Lorenzo, MD, MHA, CPE  more...
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Questions & Answers

Overview

What is the anatomy of cauda equina?

What is cauda equina syndrome (CES)?

Which spinal cord anatomical features are useful in understanding cauda equina and conus medullaris syndrome?

What is the anatomy of the cauda equina (CE) and conus medullaris?

What type of symptoms accompany conus medullaris injuries?

What is the pathogenesis of cauda equina syndrome (CES)?

What is the role of compression in the pathophysiology of cauda equina syndrome (CES)?

What causes cauda equina syndrome (CES)?

What are the most common causes of cauda equina and conus medullaris syndromes?

What are less common causes of cauda equina and conus medullaris syndromes?

What does the lack of structural pathology indicate in cauda equina syndrome (CES)?

What is the role of trauma in the etiology of cauda equina syndrome (CES)?

What is the frequency of cauda equina syndrome (CES) caused by a herniated lumbar disk?

In what conditions is cauda equina syndrome (CES) secondary to spinal stenosis?

Which primary malignancies cause cauda equina syndrome (CES)?

Which metastatic cancers may cause cauda equina syndrome (CES)?

Which inflammatory conditions may lead to cauda equina syndrome (CES)?

What are infectious causes of cauda equina syndrome (CES)?

What are uncommon causes of cauda equina syndrome (CES)?

What are possible iatrogenic causes of cauda equina syndrome (CES)?

How are cauda equina and conus medullaris syndromes classified?

How common is cauda equina syndrome (CES)?

Does the incidence of cauda equina syndrome (CES) vary by age?

How are morbidity and mortality rates of cauda equina and conus medullaris syndromes determined?

Which factors are prognostic indicators in cauda equina syndrome (CES)?

How is the ASIA) impairment scale used to predict prognosis in cauda equina and conus medullaris syndromes be predicted by?

How is ambulatory capability predicted in cauda equina and conus medullaris syndromes?

What information about cauda equina and conus medullaris syndromes should patients receive?

Presentation

What are the signs and symptoms of cauda equina and conus medullaris?

What are the most common symptoms of cauda equina syndrome (CES)?

How is back pain characterized in cauda equina syndrome (CES)?

What are the urinary symptoms of cauda equina syndrome?

What bowel dysfunction may be present in cauda equina and conus medullaris syndromes?

What types of lesions are associated with cauda equina syndrome (CES)?

Which pain and deficits of nerve roots suggest cauda equina syndrome (CES)?

Where is pain located in cauda equina and conus medullaris syndromes?

What reflex abnormalities may be present in cauda equina and conus medullaris syndrome?

When is a finding of muscle weakness suggestive of cauda equina syndrome (CES)?

Which findings of upper motor neuron involvement help to differentiate cauda equina syndrome from spinal cord compression?

How do motor and sensory symptoms differ between cauda equina syndrome (CES) and conus medullaris?

What cause overlapping symptomology between cauda equina and conus medullaris syndrome?

What are the physical findings characteristic of cauda equina and conus medullaris syndrome?

What are the motor and sensory findings characteristic of cauda equina syndrome?

What are the motor and sensory findings characteristic of conus medullaris syndrome?

Which tests should be performed during the physical exam of cauda equina and conus medullaris syndrome?

Which muscles should be assessed during a physical exam of suspected cauda equina and conus medullaris syndrome?

Which is the role of the ASIA impairment scale in the evaluation of cauda equina and conus medullaris syndromes?

What are possible complications of cauda equina and conus medullaris syndromes?

DDX

What conditions should be included in the differential diagnoses of conus medullaris syndrome?

What conditions should be included in the differential diagnosis of cauda equina syndrome (CES)?

What are the differential diagnoses for Cauda Equina and Conus Medullaris Syndromes?

Workup

How is cauda equina syndrome (CES) diagnosed?

What tests are performed in the workup of cauda equina and conus medullaris syndrome?

What is the role of imaging studies in the diagnosis of cauda equina and conus medullaris syndrome?

What is the role of lab studies in the diagnosis of cauda equina and conus medullaris syndrome?

How is bladder function assessed during the evaluation of cauda equina and conus medullaris syndrome?

How is sphincter dysfunction assessed during the evaluation of cauda equina and conus medullaris syndrome?

Which studies are performed to identify the underlying cause of cauda equina syndrome (CES)?

What is the role of radiography in the evaluation of cauda equina and conus medullaris syndrome?

What is the role of MRI in the evaluation of conus medullaris and cauda equina syndrome?

What is the role of needle EMG in the evaluation of cauda equina and conus medullaris syndrome?

Which tests are performed to rule out differential diagnoses of cauda equina and conus medullaris syndrome?

Treatment

What are treatment options for cauda equina and conus medullaris syndrome?

When should medication be initiated for the treatment of cauda equina and conus medullaris syndrome?

What is the role of tirilazad mesylate in the treatment of cauda equina and conus medullaris syndrome?

When is surgical intervention indicated in the treatment of cauda equina and conus medullaris syndrome?

What is the focus of ED treatment of cauda equina and conus medullaris syndrome?

When is hospitalization indicated for the treatment of cauda equina or conus medullaris?

What is the role of rehabilitation therapy in the treatment of cauda equina and conus medullaris syndrome?

What are goals for rehabilitation therapy of cauda equina and conus medullaris syndrome?

Which exercises should be included in the physical therapy for cauda equina and conus medullaris syndrome?

What should be included in the rehabilitation therapy for cauda equina and conus medullaris syndrome?

What should be included in occupational therapy for cauda equina and conus medullaris syndrome?

Which specialist consultations are needed for the treatment of cauda equina and conus medullaris syndrome?

What monitoring should be provided by the rehabilitation team of patients with cauda equina and conus medullaris syndrome?

When is follow-up with a physician indicated for patients with cauda equina and conus medullaris syndrome?

How are the complications of cauda equina and conus medullaris syndrome managed?

What is the role of onabotulinumtoxinA (Botox) in the treatment of cauda equina and conus medullaris syndrome?

How are pressure ulcers prevented in patients with cauda equina and conus medullaris syndrome?

How is erectile dysfunction managed in cauda equina and conus medullaris syndrome?

When are stool softeners indicated in the treatment of cauda equina and conus medullaris syndrome?

What are the treatment options for heterotopic ossification (HO) in cauda equina and conus medullaris syndrome?

How is pain associated with cauda equina and conus medullaris syndrome treated?

What is the role of lipo prostaglandin E1 in the treatment of cauda equina syndrome?

How are contractures prevented in cauda equina and conus medullaris syndrome?

When is surgical decompression indicated in the treatment of cauda equina and conus medullaris syndrome?

How does the timing of surgical intervention for cauda equina and conus medullaris syndrome affect functional outcome?

Where should patients be transferred following surgery for cauda equina and conus medullaris syndrome?

Medications

What medications are used in the treatment of cauda equina and conus medullaris syndrome?

Which medications in the drug class Phosphodiesterase (type 5) Enzyme Inhibitors are used in the treatment of Cauda Equina and Conus Medullaris Syndromes?

Which medications in the drug class Bisphosphonate Derivatives are used in the treatment of Cauda Equina and Conus Medullaris Syndromes?

Which medications in the drug class Neuromuscular Blocker Agent, Toxin are used in the treatment of Cauda Equina and Conus Medullaris Syndromes?

Which medications in the drug class Alpha 2-adrenergic Agonist Agents are used in the treatment of Cauda Equina and Conus Medullaris Syndromes?

Which medications in the drug class Benzodiazepines are used in the treatment of Cauda Equina and Conus Medullaris Syndromes?

Which medications in the drug class Skeletal Muscle Relaxants are used in the treatment of Cauda Equina and Conus Medullaris Syndromes?

Which medications in the drug class Anticoagulants are used in the treatment of Cauda Equina and Conus Medullaris Syndromes?

Which medications in the drug class Corticosteroids are used in the treatment of Cauda Equina and Conus Medullaris Syndromes?