Is cauda equina inevitable?

[ans]

Hi. As a semi-professional paranoid, I note that my recent MRI stated that I have medium to "moderate" central canal stenosis at the L4-L5 level. I have extensive DDD so the narrowing of the spine has "squashed" this level and another one to a lesser extent.

Since there's no spinal cord at this level but the compression is against the cauda equina, if I do nothing re: fusion, is getting cauda equina inevitable?

Just checking.

Thanks. - ans

[Jim M2]

Hi Allan,

I'm not sure I completely understand your question. From what I know the narrowing from stenosis and any bulged disc (from DDD) will put pressure on the nerves in the cauda equina - ouch, I think.

Jim

[Maria]

Jim
I think allan is hedging his bets re with his given spine findings and symptoms how long he might have to go before the possible development of an emergent cauda equina situation because if I'm not mistaken Allan is weighing on one hand "surgery vs. no surgery now/soon/never"

check this link out: Cauda Equina Syndrome Causes, Symptoms, Treatment and Prevention on eMedicineHealth.com

[ans]

Yes, hedging bets and trying to understand.

CES is very rare. But it seems to me that if the DDD-driven disc squashing/hence the lateral pressure on the CES - would this cause CES syndrome. (This w/ask surgeon).

I also wonder if a disectomy vs. fusion/ADR is also one way to go. I'll ask my surgical consult this on Wednesday. Hence, would draining the disc of fluid be wise or incredibly stupid?

Appreciate your input and be well.

Brr in LA.

ans

[mmglobal]

All the cases of CES I've seen (maybe 5 or 6 in the > 500 cases I've been involved in) have had to do with traumatic injuries generating huge disc herniations that were not operated on in a timely manner. Sadly, for all of these people with permanent CES who will have to don rubber gloves to manually remove feces for the rest of their lives; had they been operated on within the first few days after injury, would likely have recovered without CES. Serious bowel, bladder or sexual dysfunction related to spine problems should be dealt with sooner rather than later.... waiting for spontaneous recovery in such cases is too dangerous.

I've not seen CES in cases of spinal stenosis that was watched through the years. If serious bowel, bladder or sexual dysfunction develops; you'll deal with it on a higher priority basis than you would otherwise. As usual, this info is just my impression of my experience... I'm not a doctor and may be way off base.

Mark

[Maria]

Agreed Mark. Best to be seen ASAP if experiencing anything that resembles urinary or fecal incontinence or numbness in the perineal area/genito-rectal area. Much better to err on the side of caution than to end up with something that one might have been able to prevent.

That being said an ER wait can be lengthy in itself these days so make sure to address such needs as soon as there are symptoms.

[ans]

Thanks for the response. )

[Jim M2]

Ooooohh. There you go, I didn't even know what CES was.