The complete cauda syndrome

One speaks of a complete cauda syndrome when the entire lower spinal cord is compressed in the area of the cauda equina and the spinal nerves show a complete loss of function. Thus, the complete cauda syndrome is classified as a so-called cross-sectional syndrome. Since all spinal nerves are compressed, the entire spectrum of symptoms typical of the cauda syndrome is usually present. These include paralysis of the lower leg, foot and toe flexors and the gluteal muscles, incontinence due to paralysis of the bladder and anus muscles, loss of reflexes, as well as sensitivity disorders on the inner side of the thighs, the back of the legs and the outer edge of the foot. A complete chewing syndrome is an acute neurological emergency and should be treated by neurosurgery as soon as possible, as the risk of irreversible damage increases significantly over time.

The incomplete cauda syndrome

In incomplete cauda syndrome, only parts of the spinal nerve bundle are compressed. Therefore, there is no complete loss of function. In an incomplete cauda syndrome, the exact severity of the symptoms thus depends on the exact location of the compression on the spinal cord. For example, paralysis can only occur on one side of the body, whereas the other side is not affected. Furthermore, it is possible to detect only motor or sensory deficits without any functional impairment of urinary and fecal continence.

Symptoms of a chewing syndrome

The complete cauda syndrome is accompanied by paralysis of the lower leg, foot, toe flexor and gluteal muscles as well as other, sometimes very stressful, symptoms. Since the continence of the bladder and rectum is controlled by spinal nerves that lie below L5, cauda syndrome usually results in temporary incontinence, which can also be irreversible depending on how long it takes until therapy begins. In addition, a chewing syndrome is often accompanied by severe pain caused by compression of the spinal nerves.A further symptom of the complete chewing syndrome is loss of sensitivity in the area of the inner sides of the legs, the perineal region and the back of the legs.

Erectile dysfunction can also occur in men. The term urinary retention means that the bladder is no longer able to perform its function of urination and urine accumulates in it. The consequence of a cauda syndrome is the so-called flaccid bladder.

Here the muscles of the bladder wall no longer receive information from the spinal cord and therefore remain flaccid. Reflexes are also no longer present. Since the muscles of the bladder now receive no information to tense up and thus empty the bladder, the urine collects in the bladder.

This process can lead to the accumulation of urine, in addition to recurring urinary tract infections, and in the course of time to increasing damage to the kidneys. In order to counteract this process, one resorts to so-called intermittent self-catheterisation. In this procedure, patients can themselves insert a catheter into their bladder and thus empty it.

In addition to the case of urinary retention as described above, cauda syndrome can also lead to urinary and fecal incontinence. The former often represents a so-called overflow incontinence, which occurs when the bladder is so strongly filled with urine that it creates too much pressure. The result is unintentional urine excretion.

In fecal incontinence, the slackening of the outer sphincter muscle plays a major role, which means that defecation can no longer be controlled deliberately. The term bladder and rectum dysfunction describes a spectrum of symptoms which, in addition to urinary and fecal incontinence, includes sensory disturbances in the genital and anal areas and a residual urinary sensation. This disorder represents a neurological emergency and requires immediate clarification and treatment to prevent irreversible consequences. The most common cause of bladder and rectum dysfunction is cauda syndrome.