Ponytail syndrome takes its name from the part of the lower back known as the “ponytail,” which consists of the many nerve roots of the spinal cord. The ponytail is located at the level of the last lumbar vertebrae and the sacrum, and its roots come out of the vertebral column between the vertebrae. The nerves of the ponytail control the lower limbs and the organs in the pelvis.
When there is a compression of the nerves in this area, this is known as ponytail syndrome. This causes the afflicted individual to experience pain, loss of sensitivity, partial paralysis, or develop sphincter disorders.
Ponytail syndrome manifests itself through lumbar pains in the perineal area or in the lower limbs. These pains can often be associated with a loss of sensitivity in the genitals and anus, and in the skin of the perineum and upper thighs.
Motor disorders can also manifest themselves through an inability to walk on tiptoe or while wearing high heels, an inability to flex the thighs by the pelvis, or – in rare cases – paraplegia. Some patients can also experience impotence, constipation, incontinence, or an inability to urinate.
Diagnosis of ponytail syndrome can be confirmed by a lumbar puncture, CT scan, or MRI. This affliction can affect both men and women, of any age.
The main cause of ponytail syndrome is a herniated disc, as the intervertebral disc can compress the nerve roots of the ponytail.
A tumor located in the ponytail region can also exert pressure on the nerves, leading to ponytail syndrome.
As soon as the diagnosis of ponytail syndrome is made, treatment must begin immediately as certain symptoms can become irreversible. The condition of the patient can begin to degrade in as little as 24 hours.
Sufferers of ponytail syndrome must urgently undergo neurosurgical decompression surgery. This operation involves the removal of the tumor or herniated disc that is responsible for the affliction.
Even if the operation is successful, many patients will suffer permanent after-effects that range from difficulties walking to sexual issues. Physiotherapy, massages, and walking are recommended to improve sensation and mobility.