What is the first treatment for cauda equina syndrome?

Cauda equina syndrome occurs when the bundle of nerves below the spinal cord is compressed. These nerves help control sensation and movement in the legs and contribute to bladder, bowel and sexual function. Decompression aims to remove the pressure and limit further nerve injury. The exact operation depends on what is causing the compression, such as a disc fragment or narrowed space in the spinal canal.

This is not a condition to manage with home exercises or routine physiotherapy while waiting. An emergency team will assess strength, sensation and bladder function and may arrange scans. A laminectomy removes part of the bone forming the back of the spinal canal; a microdiscectomy removes a disc fragment pressing on a nerve. Ask the surgical team what they found, which nerves are affected and what recovery monitoring is planned.

Go to an emergency department immediately for new difficulty starting or controlling urination, loss of bowel control, numbness around the groin or inner thighs, or worsening weakness in both legs. Severe back pain with these changes also needs urgent assessment. Do not drive yourself if weakness or loss of sensation makes travel unsafe.

Which finding is compressing the nerves? Is decompression recommended now? What changes in bladder, bowel or leg function should be reported after treatment? What rehabilitation and follow-up will I need?