Serious adverse events The most common serious adverse events associated with spinal manipulation include disk herniation, the cauda equina syndrome, and vertebrobasilar accidents.
12.
The presence of cauda equina syndrome ( in which there is incontinence, weakness and genital numbness ) is considered a medical emergency requiring immediate attention and possibly surgical decompression.
13.
Cauda equina syndrome ( CES ) results from a lesion below the level at which the spinal cord splits into the cauda equina, at levels L2 S5 below the conus medullaris.
14.
Emboli to the spinal cord may cause paraparesis ( decreased power in the legs ) or cauda equina syndrome, a group of symptoms due to loss of function of the distal part of the spinal cord-loss of control over the bladder, rectum and skin sensation around the anus.
15.
In acute cases of urinary retention where associated symptoms in the lumbar spine are present such as pain, numbness ( saddle anesthesia ), parasthesias, decreased anal sphincter tone, or altered deep tendon reflexes, an MRI of the lumbar spine should be considered to further assess Cauda Equina Syndrome.
16.
Back pain, perineal pain, secondary Sciatica, secondary piriformis muscle dysfunction with tertiary sciatica, Cauda equina syndrome, neurogenic claudication ( pain caused by walking ), neurogenic bladder, dysuria, urinary incontinence, coccygodynia, sacral radiculopathy, radicular pain, headaches, retrograde ejaculation, paresthesia, hypesthesia, secondary pelvic floor dysfunction, vaginismus, motor disorders in lower limbs and the genital, perineal, or lumbosacral areas, sacral or buttocks pain, vaginal or penile paraesthesia, sensory changes over buttocks, perineal area, and lower extremity; difficulty walking; severe lower abdominal pain, bowel dysfunction, intestinal motility disorders like constipation or bowel incontinence.
