Episode 20: Cauda Equina Syndrome

Host Jimmy McKay

Featured guest Bridget Ripa

Notes Alexis Lancaster

Cauda equina: “horse’s tail”


What is it?

  • Injury to lumbar and sacral spinal nerve roots within the canal



  • Variable lower extremity paralysis
  • Sensory loss
  • Bowel and bladder dysfunction



  • Trauma, pelvic crush (MVA), child birth could precede it


Differential diagnosis

  • Other spinal cord syndromes
  • Transverse myelitis
  • MS
  • Spinal infarct
  • Spinal tumor


Special tests

  • CT, MRI
  • Clinical presentation & mechanism of injury



  • Make sure they are managed medically first
  • Bowel/bladder program
  • Motor learning
  • Task-specific training
  • ICF model
  • Weight-bearing
  • Neuromuscular re-education
  • Tone management
  • FES
  • Aerobic training
  • Positioning
  • Bracing/splinting
  • Locomotion if applicable
  • Keeping an eye on shoulder pain
  • Allow compensation in this population when they need to

How will it look on the test?

  • Mechanism of injury and clinical presentation
  • Bowel and bladder dysfunction will be present with cauda equina!