Could cervical cord compression mimic Cauda Equina Syndrome..

[lyn__0__0]

  My husband and I appreciate your help.  I am currently waining for an appt with an ortho spine surgeon on November 11th.
  An MRI of the cervical spine 3 weeks ago showed a large herniation at c6-7 which is pushing the spinal cord from right to left.  I have L'hermittes, some weakness and much pain in my neck shoulder and arms.  However the neurologist doing my EMG also found weakness in my legs.
  I have numbness in my buttocks (burned myself on a heating pad), pain from time to time in my lower back around my tailbone and frequently get moderate pain in my upper thighs bilaterally in a distribution of where a saddle would touch.   Since my MRI I have developed trouble emptying my bladder and the past 2 days have had to  use tissue to push stool out as I don't seem to be able to empty myself.
  I have been trying to figure out if my leg, buttocks and bladder problems could all be the result of the herniation at C6-7 and have had mixed answers.  Tonight I came accross information on Cauda Equina Syndrome and it seems to describe my lower symptoms.
  Do you think the cervical herniation is causing all of this or is it likely that I also have CES?
  If I have CES is there urgency in getting treatment? The bladder and bowel symptoms are quite disturbing to me.
  Thank you very much.  lyn
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Dear Lyn:
Degenerative lumbar spine disease often co-exists with cervical spine disease. Deciding whether lower extremity symptoms are from the cervical spine disease or from lumbar spine disease, or from both (with what degree of contribution form each), is usually done on clinical grounds. A careful neurological examination can be invaluable.
Symptoms of buttock numbness and sphincter involvelemt can occur with severe or advanced cervical myelopathy, but do raise the possibility of superimposed lumbar disease. The abnormal EMG in the legs apparently supports this hypothesis (cevical spine disease alone should not alter the leg EMG significantly). "Cauda equina syndrome" is generally meant to mean moderately severe involvement of multiple lower lumbar and sacral roots. I do not know if your lumbar problem is a minor one, or a major enough one to be termed cauda equina syndrome. Whether lumbar surgery is indicated is yet another question.
Operating upon the cervical spine is often an earlier priority than operating upon the lumbar spine, but this depends entirely upon the relative severity of disease at the two sites.
A neurosurgical opinion may help.