How Do You Diagnose Cauda Equina Syndrome?

How Do You Diagnose Cauda Equina Syndrome?

How Do You Diagnose Cauda Equina Syndrome

In order to diagnose cauda equina syndrome, a medical professional must carefully evaluate the patient’s history and conduct a full neurological examination. The exam is focused on sensation, strength, reflexes, stability and mobility.

Symptoms of cauda equina may include pain in the lower back that starts in the buttocks and moves to the back of the thighs. Those who have these symptoms also often suffer from loss of bowel and bladder control.



The cauda equina is a bundle of nerves that extends from the bottom of the spinal cord through the lower back bones (vertebrae) and over the base of the spine (sacrum).

Doctors often use X-rays or MRIs to help diagnose cauda equina syndrome. These diagnostic tests show a herniated disc or other injury that is compressing the cauda equina and causing symptoms.

Symptoms of new-onset cauda equina can develop quickly or gradually over weeks or months. In either case, surgery is needed to move whatever is pressing on the nerves.

Several conditions can cause cauda equina to develop, including a herniated disk, a tumor, an infection, or a condition called spondylolisthesis. The herniated disk often causes the most severe symptoms. Other causes may have less severe symptoms, but still cause pressure on the nerves, Check out the post right here.

Physical Examination

The physical examination is an important part of diagnosing cauda equina syndrome. It focuses on the patient’s symptoms and identifies areas that are abnormal or painful.

Symptoms vary from person to person and can include back pain, numbness in the legs, or tingling or burning sensations. The doctor will also check the patient’s reflexes and muscle strength.

CES is usually diagnosed as an emergency condition that requires immediate treatment to relieve pressure on nerve roots. Surgery is done to move the material that is compressing the nerves so they can heal.


A spinal X-ray can be used to determine the extent of a herniated disc that is compressing the cauda equina nerves. This can lead to permanent damage if the compression is not addressed soon enough.

The diagnosis of cauda equina syndrome involves a careful medical exam that includes a patient history, physical examination and diagnostic imaging studies. The primary imaging tests needed to diagnose this condition are X-rays, MRI and myelogram.

In many cases, an MRI scan is necessary to diagnose cauda equina Syndrome as it will clearly show whether the spinal nerves are being compressed by something (such as a herniated disk). The MRI should also reveal the cause of compression – if it is a slipped disc or a tumour – and the result is a clear understanding of the problem.


If your doctor thinks you might have cauda equina syndrome, you’ll be sent to the hospital for an MRI scan. This can tell your doctor whether the nerves in your lower spine are being compressed.

It may show signs of compression from a herniated disc (lumbar disk herniation), a tumor or an abscess in your spinal canal. These conditions can cause local pain in your lower back and legs.

The MRI scan also shows any damage to the cauda equina from pressure on its nerve roots. If your MRI shows pressure on a nerve, doctors will perform decompression surgery as soon as possible to reduce the pressure on the nerve.

It’s important to keep still during the MRI. Movement will blur or distort the pictures taken.


When a patient has symptoms that suggest cauda equina syndrome, imaging tests such as MRI or CT scans are often needed. These tests can show if pressure is being put on the cauda equina, and help doctors find the cause of the compression.

In a myelogram, contrast dye is injected into the spinal canal and X-rays or CT scans are taken. The dye allows the radiologist to see problems in the spinal cord, nerve roots and other nearby structures more clearly than with standard X-rays of the spine.


During the myelogram, you lie on your side or stomach on a X-ray table that is tilted in different directions to move the contrast dye to different areas of your spinal canal. You may also be given a sedative (by IV) to make you calm and relaxed.