Medical Treatment

Medical treatment options are useful in certain persons, depending on the underlying cause of the cauda equina syndrome. Antiinflammatory agents, such as ibuprofen (Advil, Motrin), and corticosteroids, such as methylprednisolone (Solu-Medrol, Depo-Medrol), can be effective in people with inflammatory processes, including ankylosing spondylitis.

People with cauda equina syndrome caused by an infection should receive appropriate antibiotic therapy. People with spinal tumors (neoplasms) should be evaluated for chemotherapy and radiation therapy.

Caution should be used in any medical management of cauda equina syndrome. Any person with cauda equina syndrome with symptoms of groin numbness (saddle anesthesia) and/or weakness or both legs or loss of bowel or bladder control should wait no more than 24 hours before seeking initial medical management. If no relief of symptoms is achieved during this period, immediate surgical decompression is often recommended to minimize the chances of permanent nerve injury.

Medications

People with infections or tumors (infectious or neoplastic causes) causing cauda equina syndrome should receive the appropriate antibiotics or chemotherapy for treatment of the underlying cause.

In most cases, treatment with medications alone is not indicated because of a need for emergent release of the nerve compression (surgical decompression) of the spinal canal.