What is the treatment for cauda equina syndrome?

• A. Emergent surgical decompression
• B. Steroid therapy
• C. Physical therapy
• D. Observation

Answer: (A)

Cauda equina syndrome is a neurosurgical emergency where nerve roots that control bowel, bladder, and leg function are compressed. The best treatment is emergent surgical decompression to relieve that pressure as quickly as possible, because rapid relief of compression improves the chance of preserving continence, sexual function, and motor/sensory recovery. Steroid therapy does not reliably prevent deficits and cannot substitute for removing the source of compression. Physical therapy or simply observing won’t address the underlying cause and may allow irreversible neurologic damage to progress. Diagnosis is typically confirmed with MRI, and a surgical team should be mobilized urgently to decompress, ideally within hours to a maximum of about a day from onset.