Which surgical intervention is typically required for immediate cauda equina syndrome?

• A. Laminectomy and discectomy
• B. Spinal fusion
• C. External fixation
• D. Intrathecal steroid injection

Answer: (A)

Cauda equina syndrome is a serious condition that results from compression of the cauda equina, the bundle of nerve roots at the lower end of the spinal cord. This condition often leads to neurological deficits, including loss of bladder and bowel control, sexual dysfunction, and severe lower extremity weakness. Immediate surgical intervention is critical to alleviate nerve compression and preserve neurological function.

The most common surgical approach for treating cauda equina syndrome, especially when caused by a herniated disc, is the combination of laminectomy and discectomy. A laminectomy involves the removal of a portion of the vertebrae to relieve pressure on the nerve roots, while a discectomy is the surgical removal of herniated disc material that is pressing on the cauda equina. By quickly decompressing the affected nerve roots, this surgical intervention can help restore function and reduce the risk of permanent damage.

Other options such as spinal fusion, external fixation, and intrathecal steroid injections are not indicated as immediate treatments for cauda equina syndrome. Spinal fusion is generally used for stability in cases of spinal instability rather than acute decompression. External fixation is typically employed in trauma cases involving fractures, not for direct decompression of neural elements. Intr