Comprehensive Osteopathic Medical Licensing Examination (COMLEX USA) Practice

What is the recommended treatment for cauda equina syndrome?

1. Physical therapy

2. Medication management

3. Emergent surgical decompression

4. Injections

The correct answer is: Emergent surgical decompression

Cauda equina syndrome is a rare but serious condition that results from compression of the cauda equina, which is a bundle of spinal nerves located in the lower back. The symptoms often include severe lower back pain, saddle anesthesia, bladder and bowel dysfunction, and lower extremity weakness. This syndrome requires urgent attention because the compression can lead to permanent neurological damage if not addressed promptly. The cornerstone of treatment for cauda equina syndrome is emergent surgical decompression. This procedure is aimed at relieving the pressure on the spinal nerves. Early intervention is critical, as the longer the nerves remain compressed, the higher the risk of irreversible damage and complications, including loss of bladder and bowel function and permanent motor deficits. Other treatment options, such as physical therapy or medication management, are generally inappropriate in the context of cauda equina syndrome because they do not address the underlying cause of nerve compression. While injections might help manage pain in other situations, they do not treat the immediate necessity for decompression in this acute scenario. Therefore, immediate surgical intervention is the recommended and necessary approach to restore function and prevent long-term complications.