Cauda equina ("horse's tail") is the name given to the lumbar and sacral nerve roots within the dural sac caudal to the conus medullaris. Cauda equina syndrome is usually the result of a ruptured, midline intervertebral disk, most commonly occurring at the L4 to L5 level. However, tumors and other compressive masses may also cause the syndrome. Individuals generally present with progressive symptoms of fecal or urinary incontinence, impotence, distal motor weakness, and sensory loss in a saddle distribution. Muscle stretch reflexes may also be reduced. The presence of urinary retention is the single most consistent finding (Perron and Huff, 2002).