Difference Between Cauda Equina and Sciatic Nerve

The most common pain caused by lumbar disc herniation is sciatica pain, which is somewhat similar to sciatica pain is what we often call cauda equina pain. Since there are many similarities between the two, some patients will have cognitive errors about their conditions, and some patients may even take the wrong medication, leading to unpredictable consequences. So what is the difference between the cauda equina and the sciatic nerve?

At present, the treatments for lumbar disc herniation are generally conservative, interventional, and surgical. It is recommended to first treat conservatively, and avoid surgery if possible. Surgery is the last treatment method. Generally, conservative treatments such as massage, traction, acupuncture, physical therapy, Chinese medicine, and qigong are recommended.

The cauda equina refers to the lumbar sacral nerve roots below the conus medullaris. The cauda equina is composed of 10 pairs of nerve roots originating from L2-5, S1-5 and the coccyx. The cauda equina is one of the more important nerves in the human body.

Cauda equina damage is relatively common in clinical practice. Most of the time, it is due to various congenital or acquired reasons that lead to absolute or relative stenosis of the lumbar spinal canal, compressing the cauda equina and causing a series of neurological dysfunctions. In 1949, Verbiest first reported clinically the disease and named it Cauda equina syndrome (CES)〔1〕. This paper reviews the current status of research on its etiology, pathology, clinical manifestations, diagnosis and treatment.

Cauda equina damage is relatively common in clinical practice. Most of the time, it is due to various congenital or acquired reasons that lead to absolute or relative stenosis of the lumbar spinal canal, compressing the cauda equina and causing a series of neurological dysfunctions. The best measure for CES treatment is surgery. The principle is early diagnosis, early surgery, and emergency surgery when necessary. The purpose of surgery is to relieve pressure and loosen adhesions. In order to improve the clinical cure rate, further work needs to be done: fully utilize the development of basic medical technologies such as molecular biology to further explore the pathogenesis of CES; improve surgical accuracy, accurately select surgical methods, apply microsurgical techniques, accurately position, fully decompress, prevent adhesion and postoperative scar tissue from re-compressing the cauda equina, and reduce re-injury.

The sciatic nerve is the largest nerve in the human body. It originates from the spinal cord in the lumbar region, passes through the pelvis, and exits through the greater sciatic foramen to reach the buttocks, then runs down the back of the thigh to the foot. Controls sensation and movement of the lower limbs and is composed of the lumbar nerves and sacral nerves. It is the thickest of all nerves. The sciatic nerve exits the pelvis through the inferior piriformis foramen to the buttocks, descends deep to the gluteus maximus, crosses the obturator internus muscle, the upper and lower twin muscles, and the posterior part of the quadratus femoris, innervating these muscles, and descends along the posterior side of the adductor magnus, between the semitendinosus, semimembranosus, and biceps femoris, sending muscle branches to the flexor muscles of the thigh along the way. After reaching the popliteal fossa, the sciatic nerve is divided into the tibial nerve and the common peroneal nerve, innervating all the muscles of the calf and foot, as well as the skin sensation of the calf and foot except the area innervated by the saphenous nerve.