Compression of nerves at the cauda equina - L2>

Pathophysiology

The nerves of the cauda equina supply:

• Sensation to the perineum, bladder and rectum
• Motor innervation to the lower limbs and the anal and urethral sphincters
• Parasympathetic innervation of the bladder and rectum (S3-S5 dermatomes)

In cauda equina syndrome, the nerves of the cauda equina are compressed. There are several possible causes of compression, including:

• Herniated disc (the most common cause)
• Tumours, particularly metastasis
• Spondylolisthesis (anterior displacement of a vertebra out of line with the one below)
• Abscess (infection)
• Trauma

PC

• Back pain
• Saddle anasthesia (can’t feel when wiping)
• Loss of sensation in bladder and rectum (don’t know when full)
• Urinary incontinence and retention
• Faecal incontinence
• Bilateral sciatica