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Cauda Equina Syndrome Specialist

An extension of the brain, the nerve roots send and receive messages to and from the pelvic organs and lower limbs. Cauda equina syndrome (referring to the group of nerves extending from the lower spine and resembling a “horse’s tail”) occurs when these nerve roots are compressed, cutting off sensation and movement. Nerve roots that control the function of the bladder and bowel are especially vulnerable to damage.

If patients with cauda equina syndrome do not seek immediate treatment to relieve the pressure, it can result in permanent paralysis, impaired bladder and/or bowel control, loss of sexual sensation, and other problems.

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Even with immediate treatment, some patient may not recover complete function (AAOS, 2015).

EMERGENCY RESPONSE

Although leg pain is common and usually goes away without surgery, cauda equina syndrome, a rare disorder affecting the bundle of nerve roots (cauda equina) at the lower end of the spinal cord, is a surgical emergency.
Early treatment is required to prevent permanent problems, however, cauda equina syndrome may be difficult to diagnose. Symptoms vary in intensity and may evolve slowly over time.

See your doctor immediately if you have:

  • Bladder and/or bowel dysfunction, causing you to retain urine or be unable to hold it.
  • Severe or progressive problems in the lower extremities, including loss of or altered sensation between the legs, over the buttocks, the inner thighs and back of the legs (saddle area), and feet/heels.

TREATMENT

If you have cauda equina syndrome, you may need urgent surgery to remove the material that is pressing on the nerves. The surgery may prevent pressure on the nerves from reaching the point at which damage is irreversible.
Antiinflammatory agents, such as ibuprofen, and corticosteroids 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.

PREVENTION

Prevention of cauda equina syndrome is focused on early diagnosis by identifying the symptoms described above. While low back pain with leg pain and/or weakness is a common complaint that affects many people, cauda equina syndrome is a rare complication. Doctors should be vigilant in identifying these cases. People should be educated on signs and symptoms that could suggest possible cauda equina syndrome, including change in bowel or bladder function and loss of sensation in the groin.

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Dr. Hamid R. Mir M.D.

Orthopedic Spine Surgeon & Back, Spine, & Neck Specialist

Dr Hamid Mir is a board certified orthopedic spine surgeon & back, spine, & neck specialist with fellowship training in combined neurosurgery and orthopedic spine surgery. He has offices in Orange County, Los Angeles & Riverside. Dr Mir specializes in spinal fusion, lumbar surgery and treating trauma as well as other conditions affecting the lumbar, thoracic, and cervical spine including degenerative diseases, stenosis, fracture, infection, adult scoliosis, revision, and complex reconstructions.

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Testimonials

You are more than just a patient.

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I was in a very bad situation with a herniated disc in my lower back so I made an appointment with DISC spine center and Dr. Hamid. He was very professional and made me comfortable that he understood exactly what I was going through and was able to communicate effectively exactly what it will take to get me on the road to recovery after spine surgery. It took several months as my injury was severe however I always felt I was in good hands under Dr. Hamid’s supervision…If you ever have the misfortune of injuring your circuit board of your body (spine) you need a pro, do not take advice from anyone who’s not specifically licensed to help, Dr Hamid is who I chose and I’m very thankful.

- Matteo B

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Dr. Mir saw me about 2 months before the spine procedure and indicated that I had severe stenosis or narrowing of the openings where the nerve roots exit at the L4, L5 and S1 level. He reviewed my MRI and without wasting any time, asked if I wanted or was considering spinal surgery. He was extremely clear and answered all my questions. I had the procedure done at the Disc Newport OP surgery spine center and was cared for by an incredibly competent, caring staff. I was discharged same day and my post op recovery was 2 weeks, and returned to daily activities and work July 15th. The procedure was very successful as my back pain is basically gone. Amazing relief from a procedure done by a great surgeon with a great team!

- Stan W.

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Dr Mir is an excellent spine surgeon. I had a surgery on my neck by another surgeon but I was still in pain. A friend who had prior spine surgery with Dr. Mir recommended him to me. As the treating surgeon he was very detail oriented, confident, and knowledgeable. His team is very friendly and helpful. I decided to have a second cervical spine operation on my neck. Soooo thankful I have no pain and for physical medicine doctors like him.

- Hillary C.

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Dr. Mir and his entire team of specialists take the extra time and consideration to shape alternatives to meet the needs (holistically) of the patient. Everything about the experience of my surgery was positive. Dr. Mir is a patient and compassionate surgeon. His communication skills are remarkably attentive. We are six months out of the starting gate from surgical treatment, and with PT and core strengthening exercises, this 65 yr. old is back to regular training for next year’s marathon. Thank you kindly El Doc-tor….you are amazing! See you soon.

- Lorena B.

Dr. Hamid Mir is a member of American Board of Orthopedic Surgery with fellowship training in combined neurosurgical and orthopedic spine surgery at Cedars Sinai Medical Center in 2004. As a top rated spine surgeon, he specializes in cervical, thoracic, and lumbar spine diseases including degenerative, stenosis, fracture, infection, scoliosis, revision, and complex reconstructions.

Dr. Mir focused his practice on minimally invasive techniques. As Medical Director of DISC Sports & Spine Center, Dr. Mir is at the forefront of the field of minimally invasive spine surgery. The benefits of these techniques include less post-operative pain, quicker recovery reduced blood loss, less soft tissue damage, smaller surgical incisions, less scarring and improved function.

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