CES made simple CES made simple Cauda Equina Syndrome Cauda Equina is taken from the Latin name and means "Horse's tail". The name describes the bundle of nerve roots that emerge form the end of the spinal cord, resembling a horse's tail. These nerve roots serve the bladder, bowels, sexual function and lower limbs. The syndrome occurs when the nerves are compressed and cause a set of symptoms called "The Red Flags". Compression of these nerve roots can be caused by spinal stenosis, tumours, cysts, stabbings, gunshot wounds or fractures, but most commonly cauda equina syndrome occurs when there is a large central disc herniation (slipped disc) in the lower back. Cauda Equina Syndrome is a Medical Emergency If a person presents with the red flags, some or all, together with bilateral sciatica and acute low backpain then cauda equina syndrome must be ruled out. A comprehensive assessment of the patients symptoms must be undertaken. If necessary the patient should be referred for an emergency MRI scan to diagnose the condition, a confirmed diagnosis will require emergency decompression within 24 hours. Delays to neurological assessment and scanning, hospital transfers and treatment can lead to devastating life changing injuries for the patient. These include bladder and bowel incontinence, sexual dysfunction, a range of mobility issues, chronic pain and fatigue, Coupled with a lack of adequate care provision and rehabilitation for many cauda equina syndrome patients, delays can lead to long term depression, isolation and trauma. All of these severely impact the quality of life for many patients and their families.