Cauda Equina Syndrome
(CES; Compression of Spinal Nerve Roots; Syndrome, Cauda Equina; Spinal Nerve Roots, Compression)
How to Say It: COW-da Ee-KWI-nah
by Cynthia M. Johnson, MA
Cauda equina syndrome (CES) is compression of the nerve roots at the base of the spinal cord. The nerve roots (known as the cauda equine) control the sensation and function of the bladder, bowel, sexual organs, and legs. It is rare.
Care is needed right away to avoid long-term damage.
The most common cause is a herniated disc. Discs are semi-soft tissue between the bones (vertebrae) of the spine. The discs act as the spine’s shock absorbers. A disc that pushes into the spinal canal can press against the bundle of nerves and cause CES.
Other causes may be:
Things that may raise the risk of this problem are:
CES may cause:
The doctor will ask about your symptoms and health history. A physical exam will be done. The doctor will look for signs of nerve problems. A rectal exam may be done to check anal function.
Images may be taken of the spine and nearby structures. This can be done with:
Underlying causes will need to be treated. Emergency care may also be needed. Choices are:
Surgery may be done to ease compression on the nerves. Choices are:
Symptoms may be managed with medicines, such as:
Therapy may be needed to regain lost skills. Options are:
There are no known guidelines to prevent this health problem.
Cauda Equina Syndrome Resource Center
United Spinal Association
Canadian/American Spinal Research Organizations
Spinal Cord Injury Canada
Bydon M, Lin JA, et al. Time to surgery and outcomes in cauda equina syndrome: an analysis of 45 cases. World Neurosurg. 2016;87:110-115.
Cauda equina syndrome. American Academy of Orthopaedic Surgeons Ortho Info website. Available at:
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Accessed January 14, 2021.
Cauda equina syndrome. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cauda-equina-syndrome. Accessed January 14, 2021.
Last reviewed December 2020 by EBSCO Medical Review Board Rimas Lukas, MD
Last Updated: 1/14/2021