Nerve compression leading to permanent nerve damage is measured in percentages. That is, it is difficult to determine if the nerve will recover in many cases. I use motor weakness as my guide. If there is appreciable weakness and dysfunction of a motor group due to compression, I generally advise a decompression surgery sooner than later. Even with surgery, this does not guarantee recovery but a much higher chance of recovery.
Even if there is no motor weakness present but only the presence of pain and paresthesias (pins and needles), leaving this nerve compression can still cause permanent motor damage if the pressure is there severe and long enough. There are times however that decompression surgery even a year after the compression and symptom presence will fully cure the symptoms.
Cauda equina symptoms are something altogether different. If there is enough canal compression to compress the nerves to the bowel and bladder (Nervi Erigantes), this should be decompressed quickly. L4 nerve compression will not cause caudal equina syndrome but pain can mimic the presence of this disorder.
Dr. Corenman
PLEASE REMEMBER, THIS FORUM IS MEANT TO PROVIDE GENERAL INFORMATION ON SPINE ANATOMY, CONDITIONS AND TREATMENTS. TO GET AN ACCURATE DIAGNOSIS, YOU MUST VISIT A QUALIFIED PROFESSIONAL IN PERSON.
Donald Corenman, MD, DC is a highly-regarded spine surgeon, considered an expert in the area of neck and back pain. Trained as both a Medical Doctor and Doctor of Chiropractic, Dr. Corenman earned academic appointments as Clinical Assistant Professor and Assistant Professor of Orthopaedic Surgery at the University of Colorado Health Sciences Center, and his research on spine surgery and rehabilitation has resulted in the publication of multiple peer-reviewed articles and two books.
