What is cauda equina syndrome?
At each level of the spine, there are nerves branching off from your spinal cord, which are called nerve roots. They are responsible for sending signals to and from the muscles and other structures throughout the body. The area of the spine below where the spinal cord finishes is the group of nerves which are called the cauda equina. These nerves spread out from the bottom of the single spinal cord, much like a horse’s tail.
The nerves of the cauda equina are responsible for the supply of nerves to the bladder, bowels, and lower limbs, and also supply sensation to the skin around the bottom, back passage and the area between the legs.
Cauda equina syndrome refers to the signs and symptoms when the nerves of the cauda equina are compressed. When this occurs urgent medical attention is required as there is a limited window of time in which to take action to decompress the nerves. If this doesn’t happen, it could result in permanent damage or long-lasting devastating physical and neurological problems, which include incontinence and paralysis.
Simon Sansome
Matthew Olner from our Medical Negligence team acted for Mr Simon Sansome in a complex, difficult and ultimately successful cauda equina claim. Simon was a healthy and active newly married 32-year-old when he suffered avoidable cauda equina injuries that left him severely injured and wheelchair-bound.
Simon has gone on to become a champion for disabled rights. He has also agreed to take part in an award-winning film called “Access All Areas.” The film tells the story of his injury and journey through the claim process. It’s easy for us specialists to forget sometimes just how daunting and bewildering a complex clinical negligence claim can be for people. You can watch the film on Amazon Prime or watch the trailer.
What are the causes of the syndrome?
Compression of the nerve roots is generally caused by disc herniation in the lower region of the back. There are, however, other causes, such as:
- Spinal stenosis (narrowing of the spinal canal)
- Lesions and tumours
- Epidural abscesses
- Infections or inflammation
- Trauma to the lower back
- Spinal anaesthesia
- Spinal haemorrhages
- Postoperative spinal surgery issues
What are the symptoms of cauda equina syndrome?
The condition is typically accompanied by a variety of medical symptoms and the severity of these symptoms will be dependent on the degree of compression and the precise nerves that have been compressed.
The following signs and ‘red flag’ symptoms may indicate cauda equina syndrome:
- Lower back pain
- Leg pain, numbness or weakness
- Pain that radiates down the leg
- Numbness in the saddle region (between the legs) and buttocks
- Loss of bowel or bladder control
- Sexual problems
The symptoms usually start suddenly and progress quickly although in some cases the symptoms can start slowly. If someone starts to experience any of these symptoms then they should seek medical attention without delay. Time is of the essence.
How is cauda equina syndrome diagnosed?
The usual method of diagnosis is through an MRI scan and this should be done when any suspicion of the condition is had. Other possible diagnosis methods are a CT scan, myelogram and tests of bladder control.
Medical history and physical exams are also extremely important when diagnosing cauda equina syndrome.
How is it treated?
Once the condition has been diagnosed, urgent surgery is often needed to relieve the pressure on the impacted nerves. The sooner decompression surgery takes place the better the chance of preventing permanent physical and neurological problems, such as incontinence and paralysis.
Treatment within 48 hours from the onset of cauda equina syndrome is ideal and provides a substantial advantage in improving sensory and motor deficits, along with urinary and rectal function.
Cauda equina syndrome negligence compensation claims
Even though the condition is considered rare, there are a high number of negligence claims bought each year.
This is due to the small window of opportunity in which cauda equina syndrome can be treated and if the window is missed the patient can be left with permanent physical and neurological injuries.
Successful cauda equina syndrome negligence compensation claims have included:
- Delay in performing decompression surgery
- Failure to recognise red flag symptoms
- Failure to investigate red-flag symptoms
- Delay in carrying out scans
- Radiologist misinterpreting an MRI scan leading to the diagnosis being missed
This list is not exhaustive and it is always worth obtaining legal advice, regardless of the circumstances surrounding the diagnosis and treatment of cauda equina syndrome.
How we can help
Matthew Olner is a Partner in our Medical Negligence team, which is ranked in Tier One by the independently researched publication, The Legal 500, and Commended in The Times Best Law Firms 2023. Our team in Derby, Leicester or Nottingham is vastly experienced in advising on cauda equina syndrome negligence compensation claims.
If you are concerned there was a delay in the diagnosis or treatment of cauda equina syndrome, mistreatment, or any other negligence regarding your care, we are here to help you. Please contact us on 0800 024 1976 or complete our contact form and we will contact you as soon as possible.
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