Cauda equina syndrome (CES) is a rare but life-altering disease resulting from compression of the nerve roots at the spinal cord's terminus. CES typically presents with low back pain, sciatica, sensorimotor deficits, and bowel and bladder dysfunction. Owing to its rarity, the condition is often missed, leading to significant morbidity and potential legal implications for physicians.
This review synthesizes the current literature on CES, including its epidemiology, pathophysiology, classifications, and management strategies. Emphasis is placed on the diagnosis and treatment of CES as well as the legal implications of CES for spine surgeons.
Surgical decompression remains the definitive treatment of CES, though the timing of surgery requires careful consideration to balance the urgency of intervention with the risks of complications. Further research is needed to explore strategies that would allow for improvement in identifying and treating patients with CES in a timely manner.
Level of evidence: Level V. Published abstract, JBJS Rev 2025. Copyright remains with the authors and publisher.
Cauda equina syndrome (CES) is a rare but life-altering disease resulting from compression of the nerve roots at the spinal cord's terminus. CES typically presents with low back pain, sciatica, sensorimotor deficits, and bowel and bladder dysfunction. Owing to its rarity, the condition is often missed, leading to significant morbidity and potential legal implications for physicians.
This review synthesizes the current literature on CES, including its epidemiology, pathophysiology, classifications, and management strategies. Emphasis is placed on the diagnosis and treatment of CES as well as the legal implications of CES for spine surgeons.
Surgical decompression remains the definitive treatment of CES, though the timing of surgery requires careful consideration to balance the urgency of intervention with the risks of complications. Further research is needed to explore strategies that would allow for improvement in identifying and treating patients with CES in a timely manner.
Level of evidence: Level V. Published abstract, JBJS Rev 2025. Copyright remains with the authors and publisher.