Cauda Equina Syndrome

Symptoms:
1. Severe lower back pain
2. Pain radiating down the legs (sciatica)
3. Saddle anaesthesia (numbness in the perianal region, inner thighs, and buttocks)
4. Urinary retention or difficulty initiating urination
5. Fecal incontinence or loss of bowel control
6. Lower extremity weakness and reduced reflexes

Diagnosis:
i. Clinical Examination: Assessment of sensory and motor function, reflexes, and perianal sensation.
ii. Imaging:
iii. MRI: Urgent MRI of the lumbosacral spine is the gold standard for diagnosing cauda equina syndrome.
iv. CT Myelography: An alternative if MRI is contraindicated.

Management:
. Urgent Referral: Immediate referral to a neurosurgeon or orthopaedic surgeon.
. Surgical Decompression: Emergency surgery to relieve pressure on the cauda equina nerves.
. Postoperative Care: Includes rehabilitation to restore function and manage any residual neurological deficits.