Cauda Equina Syndrome is a medical condition caused by severe damage to the cauda equina which is a bundle of nerves branching away from the end of the spinal cord. It’s Latin for “horse’s tail”. These nerves send and receive messages to and from the legs and feet, and pelvic organs, including the bladder and sexual organs. They extend from the lumbar spine and are susceptible to compression damage in some situations, which can lead to Cauda equina syndrome (CES). Intervertebral discs can become dislocated to in people with CES, contributing to the compression.
Typically, CES occurs in adults (rarely in children) but the symptoms bear some similarity to those of cerebral palsy. In fact, CES seems to affect mainly middle-aged individuals and often following involvement in accidents. It’s a crippling condition, affecting the spinal canal nerve roots and requires diagnosis and treatment within 24-48 hours to prevent permanent damage. A delay in diagnosis and treatment (i.e. cauda equina negligence) could lead to permanent, irreversible, life-changing effects, which can include:
~ Bladder weakness (urinary incontinence)
~ Bowel weakness (fecal incontinence)
~ Limb weakness (much like cerebral palsy)
~ Sexual dysfunction (can tax relationships)
Traumatic injuries to the spinal cord occur annually in the UK to an average of 15 people per million, without discrimination. Most are the result of trauma due to falls, car accidents, sports injuries (and other causes). An estimated 10-25 percent of vertebral fractures result in spinal cord injuries, requiring a thorough physical examination. Without it, as many as 5-15 percent of trauma patients could have a serious fracture that will initially go undiagnosed. Most of these injuries are to the cauda equina, especially between the T12 and L2 vertebrae. Disc herniation is the most common CES cause and one to two percent of all surgical cases involving disc herniation result in CES. Dislocated intervertebral discs can become so to varying degrees, which can contribute to compression.
CES is usually treated surgically with a laminectomy (a procedure which removes part of a spinal disc for relieving pressure on the cord), however permanent sexual dysfunction, urinary problems, and/or numbness can occur even after surgery. In fact, poor outcomes occur in approximately 20 percent of patients following treatment and about 1 in 70,000 individuals are affected annually by CES (first described back in 1934).
There are two types of CES:
1. Incomplete CES
When CES is “incomplete”, patients generally suffer from bladder problems (i.e. urinary sensation difficulty, problems in knowing when to urinate), straining to urinate, or a weak urinary stream. Also, the genital sensory defect will often be partial or unilateral with no discrimination regarding age or sex.
2. Complete CES
“Complete” Cauda Equina syndrome is usually characterised by painless urinary retention, as well as overflow incontinence due to incomplete bladder control. Extensive to complete genital sensory defect is usually present.
Outcomes for incomplete CES patients who undergo compression release surgery is usually much more favourable than for those who suffer from complete CES where the overall prognosis is generally much poorer.
It’s crucial that CES gets diagnosed promptly following initial symptoms, especially after a serious accident. Your doctor will generally make a CES diagnosis based on a number of important factors. When a CES diagnosis is suspected (based on symptoms), it is usually confirmed with medical imaging (CT scan or MRI).
CES is usually caused by the herniation of a lower back disc. Other causes can include:
1. Cancer (malignant tumour or spinal lesion)
2. Epidural abscess
3. Epidural hematoma
4. Slipped disc
5. Spinal fracture, hemorrhage, infection, or inflammation
6. Spinal stenosis (spinal canal narrowing)
7. Trauma (complications from car accidents or a fall resulting in a serious lumbar spine injury).
The symptoms of Cauda Equina Syndrome include but are not limited to:
• Severe back pain
• Dysfunction in bladder and bowel function, generally caused by a decrease in muscle tone involving the anal and the urinary sphincters. This weakness can cause both urinary-retention, as well as residual post-voiding incontinence, which is assessed via a scan following urination.
• Anesthesia involving the anus, external genitalia, and the perineum, often described as pins-and-needles or numbness in inner thighs and/or the groin, described as similar to discomfort and pain from riding a horse.
• Pain similar to sciatica, on one or both sides.
• Weakness in lower leg muscles and/or numbness causing mobility problems, including stumbling and difficulty in getting up i.e. when standing up from a chair.
• Sudden onset sexual dysfunction that could lead to relationship problems/divorce if left untreated.
• Absence of anal reflexes
• Disturbance in gait
• Altered sensations in back of legs, buttocks, inner thighs, or feet which are severe and/or worsening
• Any of the above symptoms are considered to be red flag symptoms, requiring urgent investigation. Delayed diagnosis could be life-changing.
Cauda Equina Syndrome can affect all aspects of life, including your professional, business, domestic, and social life. Patients suffering from CES experience compression of their spinal nerve roots. Failure to diagnose and treat could lead to long-term devastating consequences. If CES symptoms are misdiagnosed or ignored, the neurological effects could be serious and decompression surgery for relieving spinal pressure should occur as soon as possible.
Our experienced solicitors have seen the severe impact CES can have on a victim’s life, as well as the many changes that he/she has been forced to make. They are expertly equipped to helpyou with your cauda equina claim if your life has been affected by this condition.
Due to the nature of CES, most sufferers have been found toexperience specific debilitating issues that patients suffering from other ailments or injuries never have to endure, including:
A. Lack of awareness at hospital-
Medical staff at many hospitals might not be aware of CES signs or the necessity for quick action and the devastating
impact this syndrome can have on patients’ lives. In fact, the systematic failures of many smaller hospitals could mean they’re not suitably equipped for dealing with those severe spinal injuries which require urgent investigating and referral to a specialist unit. Lack of awareness often leads to misdiagnosis.
B. Delayed CT Scan or MRI-
CES sufferers often face days or weeks of delays before undergoing a scan. While waiting, their condition could be
deteriorating so quickly and significantly that it could end up being too late to prevent permanent nerve damage, causing permanent life-changing effects.Speed is critical in CES cases, urgent investigation by MRI scan is absolutely crucial.
C. Misdiagnosis by General Practitioners-
Although the majority of GPs are aware of CES, the need for immediately referring CES-sufferers to hospital for scans and/or surgery may go unheeded and some GPs end up letting their patients down by misdiagnosis and failing to recommend appropriate action.
D. Poor Standards of Surgery-
This can worsen a patient’s condition or even leave CES untreated, which could lead to permanent damage and necessiate further operations. This can be exceptionally traumatic for patients and they can also be facing a heightened risk of permanent damage.
E. Postoperative Complications-
The medical negligence could stem from failure to recognise CES complications following surgery.
You can claim for cauda equina recompense if a doctor or hospital was guilty of clinical negligence and/or guilty of misdiagnosis and/or there was a failure to refer you promptly, which affected the outcome of the necessary neurosurgery. The window of opportunity for diagnosing and treating cauda equina syndrome is very narrow. Many experts say that it is less than 36 hours or failure and misdiagnosis could cause irreversible damage. Cauda Equina Syndrome can often be caused and/or worsened by medical negligence. If you or a loved one are affected, you may be eligible for claiming compensation.
If you’ve suffered from CES, you could be a victim of clinical negligence and could suffer permanent injury, which means that you may have a valid claim for cauda equina settlements. Our law experts will support and help you with getting your life back on track. If your CES was misdiagnosed or caused by other medical negligence, e.g. late diagnosis or failure to diagnose, and you were left permanently injured, are currently suffering from incontinence, saddle anesthesia, and/or other CES symptoms, some of which may have led to signing divorce agreements (like sexual dysfunction), then our legal team can assist you with your cauda equina medical negligence compensation claim and settlement agreements.
If you have suffered from a medical injury involving your your spine, rest assured that our medical negligence specialists have the vital expertise necessary to draft all necessary agreements and successfully obtain significant cauda equina syndrome compensation on your behalf.
Most medical experts agree that sufferers of cauda equina syndrome should be undergoing surgery to make more space for accommodating pressured nerves within the first 48-hours from their diagnosis to have the best chanceof achieving complete recovery. The spinal injury claims solicitors at MRH Solicitors have successfully secured compensation in claims against the medical profession when theyfailed to diagnose CES until too long after that period had passed, or who have caused CES because of clinical negligence.
Significant financial compensation could be yours if you can demonstrate that there was:
• A failure in diagnosing CES
• A failure to properly treat the condition
• Negligent or inadequate surgery
• A failure to recognise any postoperative complications
The effects of any of the above are usually extensive, which is why CES settlements are often substantial. When you seek advice from cauda equina specialist medical negligence solicitors, it could have significant influence on your compensation claim’s outcome. We’ve got a reputation for successfully pursuing CES cases and the recovery of substantial compensation for clients just like you.
• There is a high level of stress associated with being admitted to hospital since CES is an emergency condition. It is often accompanied by degenerative disease and, although treatment is free in the UK (under the National Health Service) for most patients, disruptive hospital stays can usually last several days.
Since failure to promptly diagnose and/or treat CES can lead to lifelong permanent disability, if you can establishreceiving substandard medical care leading to an avoidable CES injury, you could receive significant compensation. Examples of compensation types include (but aren’t limited to):
• Award of damages for a CES injury itself. Resulting impairments could include urinary and/or bowel incontinence, necessary urinary catheterisation, need for physical therapy and pelvic floor exercises when muscles are damaged and paralysis or weakness in the lower extremities is present. Sexual function can be affected, especially in the presence of limited bowel and bladder control. This can negatively affect relationships and lead to divorce. The compensation amount depends upon any chance of recovery being present, or whether the injury turns out to be permanent. This type of medical negligence claims award will generally not result in any tax repercussions.
• Coverage for any further high cost surgery.
• Physiotherapy costs, plus the cost of occupational therapy or therapies needed for helping to relieve or improve CES symptoms.
• Lost earnings when earnings potential and ability to work and retain employment has been affected.
• Being handicapped in the job market due to injury-related disadvantages.
• The high cost of care when the CES injury means that an individual can’t look after themself and perform everyday duties like shopping or housework and those tasks will need paid caregivers.
• Any specific equipment needed for helping patients manage their disability.
• Our cauda equina solicitors work harder to ensure that you win maximum cauda equina compensation payouts amount and enable you to get on with your life.
We have a track record in CES medical negligence compensation claims for clients who’ve suffered from CES caused by medical negligence. We have built a solid reputation as cauda equina syndrome claims specialists. Our knowledgebase and highly professional approach have made a big difference in the lives of our clients. We have not only acquired compensation settlements, letting them start rebuilding their lives, but we also provide an excellent source of support at an exceptionally challenging time in their lives, which can tax not only the emotional wellbeing of the patient but that of their family as well.
Contact our medical negligence team of specialising solicitors if you, or a loved one, is suffering from Cauda Equina syndrome and you have serious concerns regarding the standard of medical care that was received during the diagnosing and/or treating of this condition.
We are a group of lawyers operating under the strict supervision of the Solicitors Regulation Authority, which is responsible for overseeing 180,000+ solicitors all over England and Wales.
We will offer you our best advice regarding whether we feel that we can help you with investigating a claim for CES medical negligence compensation. For more in-depth information and/or to request our office to schedule your free confidential legal consultation with an expert cauda equina solicitor who is authorised and regulated by the solicitors’ regulator (the SRA), just phone our CES experts on 01204 540 880 now.