Cauda Equina Syndrome is a medical condition which manifests when the cauda equina sustains severe damage. The cauda equina is a bundle of nerves which branch away from the end of the spinal cord. It’s a Latin word meaning “horse’s tail” and these particular nerves are responsible for sending and receiving messages to and from the legs and feet, as well as the pelvic organs, including the bladder and sexual organs. These nerve roots extend from the lumbar spine and in some circumstances are susceptible to compression damage, which can lead to Cauda equina syndrome (CES). In addition, intervertebral discs can become dislocated to varying degrees in people with CES, and thereby contribute to the pressure and compression.
Typically, CES occurs mainly in adults and rarely in children but the symptoms bear some similarity to those of cerebral palsy. In fact, CES seems to affect mainly individuals who are middle-aged and often following involvement in accidents. It’s a crippling condition, affecting the spinal canal nerve roots and requires diagnosis and treatment within 24 to 48 hours to prevent permanent damage. A delay in diagnosis and treatment (i.e. cauda equina negligence) could lead to permanent, irreversible and life-changing effects, which can include:
~ Bladder weakness (urinary incontinence)
~ Bowel weakness (fecal incontinence)
~ Limb weakness (much like cerebral palsy)
~ Sexual dysfunction (which can tax relationships)
Traumatic injuries to the spinal cord occur annually in the UK to an average of 15 people per million, without discrimination. The majority of them are the result of trauma due to falls, automobile accidents often caused by heavy road traffic, all types of sports injuries, and several other factors. In fact, an estimated 10 to 25 percent of vertebral fractures result in spinal cord injuries, requiring a thorough physical examination. Without it, as many as 5 to 15 percent of trauma patients could have a serious fracture that will initially go undiagnosed. The most frequent of these injuries are injuries to the cauda equina, especially between the T12 and L2 vertebrae. Disc herniation has been reported to be 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 dislocated to varying degrees, which can contribute to compression.
CES is usually treated surgically with a laminectomy (a surgical procedure which removes part of a spinal disc for relieving pressure on the spinal 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, which was first described back in 1934.
There are actually two types of CES, including:
1. Incomplete CES
When CES is described as “incomplete”, patients generally suffer from bladder problems (i.e. urinary sensation difficulty, which is a difficulty in managing to know when to urinate), straining to urinate, or a weak urinary stream. In addition, the genital sensory defect will often be partial or unilateral with no discrimination regarding the age or sex of the patient.
2. Complete CES
“Complete” Cauda Equina syndrome is usually characterized by urinary retention that is painless as well as overflow incontinence due to the fact that the bladder isn’t completely under control anymore. Also, extensive to complete genital sensory defect is usually present.
It’s a fairly well-known fact that outcomes for incomplete CES patients when compression release surgery is performed is usually much more favorable than for those who suffer from complete CES where the overall prognosis is generally quite a bit poorer.
It’s crucial that CES gets diagnosed promptly following the onset of initial symptoms, especially following any serious accident. Your doctor will generally make a CES diagnosis based on a number of important factors. When a CES diagnosis is suspected (based upon the symptoms), it is usually confirmed via the use of medical imaging (CT scan or MRI).
The cause of CES is usually the herniation of a disc in the lower back, however other causes can also include:
1. Cancer (malignant tumor or spinal lesion)
2. Epidural abscess
3. Epidural hematoma
4. Slipped disc
5. Spinal fracture, hemorrhage, infection, or inflammation
5. Spinal stenosis (spinal canal narrowing)
6. Trauma (complications from automobile accidents or a fall resulting in a serious lumbar spine injury).
The symptoms of Cauda Equina Syndrome include but are not limited to the following:
• Severe back pain
• Dysfunction in the bladder and bowels, which is 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 by the patient.
• Anesthesia involving the anus, external genitalia, and the perineum that is often described as pins-and-needles or numbness in inner thighs and/or the groin, which is described as similar to the discomfort from riding a horse.
• Pain that is likened to sciatica on one or both sides.
• Weakness in lower leg muscles and/or numbness causing mobility problems, including stumbling as well as any difficulty in lifting up i.e. when standing up from sitting in a chair.
• Sexual dysfunction that comes on suddenly and could lead to relationship problems/divorce if left untreated.
• Absence of anal reflexes
• Disturbance in gait
• Altered sensations in the back of the legs, buttocks, inner thighs, or feet which are severe and/or increasingly worsening
• Any of the above symptoms are considered to be red flag symptoms, requiring urgent and immediate investigation. A delayed diagnosis could be life-changing.
Cauda Equina Syndrome can have an effect on all aspects of life, including your professional, business, domestic, and social life. Patients suffering from CES experience compression of their spinal nerve roots and failure to receive diagnosis and treatment could lead to long-term devastating health consequences. If CES symptoms are misdiagnosed or ignored, the neurological effects could be serious and decompression surgery for relieving the spinal pressure should occur as soon as possible.
Our experienced cauda equina solicitors fully understand the severe impact that CES can have on a victim’s life as well as the many changes that he/she have been forced to accept and are very well equipped to start helping you with your cauda equina claim in the event that your life has been forever changed by this condition.
Due to the nature of CES, it has been found that most sufferers have experienced specific debilitating issues that patients who suffer from other types of ailments or injuries have never had to endure, including:
A. A lack of awareness at a hospital-
The medical staff at many hospitals might not be aware of the CES signs or even the necessity for taking quick action and the devastating impact that the 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 as well as referral to a specialist unit. This lack of awareness often leads to misdiagnosis.
B. Delayed CT Scan or MRI-
CES sufferers are often facing days or even weeks of delays before undergoing a scan. While they wait, their condition could be deteriorating so quickly and significantly that it could end up being too late for the prevention of permanent nerve damage, causing lives to be literally turned upside down. Speed is critical in CES cases, making the urgent investigation by an MRI scan absolutely crucial.
C. Misdiagnosis by General Practitioners-
Although the majority of GPs are well aware of CES, the need for immediately referring CES-sufferers to a hospital for scans and/or surgery may go unheeded and some GPs end up letting their patients down by misdiagnosing their condition and failing to recommend appropriate action.
D. Poor Standards of Surgery-
This can result in the worsening of a patient’s condition or even CES being left untreated, which could end up leading to permanent damage and the necessity of further operations. This can be exceptionally traumatic for patients and they can also be facing a heightened risk of resultant permanent damage.
E. Postoperative Complications-
The medical negligence could stem from the failure to recognize CES complications following surgery.
You can claim cauda equina compensation if a treating physician or hospital was negligent and/or guilty of misdiagnosis and/or there was a failure to refer you in a timely manner, which affected the outcome of the necessary neurosurgery. The window of opportunity for diagnosing and treating cauda equina syndrome is very narrow. In fact, many medical experts say that it is less than 36 hours or failure and misdiagnosis could be causing irreversible damage. Cauda Equina Syndrome can often be caused and/or worsened by medical negligence and if you or a loved one are affected, you may be eligible for claiming compensation.
If you have suffered from CES, you could be a victim of medical negligence and, as a result, could suffer permanent injury, which means that yours may be one of the many valid claims for cauda equina syndrome. Our solicitors are here to support you and help you with getting your life back on track. In the event that your CES was misdiagnosed or caused by other medical negligence, such as late diagnosis, and you were left with a permanent injury, 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 solicitors can assist you with your cauda equina medical negligence compensation claim and settlement agreements.
So, if you have suffered from a medical injury that involved your back or your spine, you can rest assured that our medical negligence solicitors have the extensive expertise necessary to draft all of the necessary agreements and successfully obtain significant compensation on your behalf.
The majority of medical experts agree that individuals suffering from cauda equina syndrome should be undergoing surgery for making more space to accommodate the nerves (aka lumbar decompression) within the first 48-hours from their diagnosis so that they have the optimum chance of achieving a complete recovery. And, the fact is that the spinal injury claims solicitors at MRH Solicitors have been successful at securing compensation in claims against the medical profession when they failed to diagnose CES until too long after that period had passed, or who have caused CES because of a negligent surgery.
Significant financial compensation could be received 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 recognize any postoperative complications
• The effects of any one or more of the above can be (and usually are) quite extensive, which is why CES settlements are often substantial. When you seek the advice of a cauda equina medical negligence specialist (sooner rather than later), it could have a significant influence on your compensation claim’s outcome. We have built up a reputation for successfully pursuing CES cases and the recovery of substantial compensation for clients just like you.
• There is a significantly high level of stress associated with being admitted to a hospital since CES is considered to be 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, hospital stays can usually last four to five days and disrupt lives.
Since failure to promptly diagnose and/or treat CES can lead to lifelong permanent disability, if you are able to establish the fact that you received substandard medical care leading to an avoidable CES injury, you could receive significant compensation. A few examples of those types of compensation include (but are not limited to):
• An award of money damages money for a CES injury itself. The resulting impairments could include urinary incontinence and/or bowels, necessary urinary catheterisation, and a need for physical therapy and pelvic floor exercises when the muscles have sustained damage and paralysis or weakness in the lower extremities is present. In addition, sexual function can be adversely affected, especially in the presence of limited bowel and bladder control. Of course, this can negatively affect relationships and even lead to divorce. The compensation amount is dependent upon the presence of any chance of recovering, or whether the CES injury turns out to be permanent. This type of medical negligence claims award generally will not result in any tax repercussions.
• Coverage for the high cost of any further surgery.
• Physiotherapy costs, as well as the cost of occupational therapy or any other therapies needed for helping to relieve or at least improve CES symptoms.
• Lost earnings when earnings potential and the ability to work and retain employment has been affected.
• Being handicapped in the job market due to the disadvantages caused by the CES injury.
• The high cost of care when the CES injury sustained means that an individual is unable to administer self-care anymore and can’t perform everyday duties like shopping or housework and those tasks will have to be performed by paid caregivers.
• Any specific equipment and aids needed for helping patients manage their disability.
• Our cauda equina compensation solicitors will work hard to ensure that you win the maximum compensation amount needed for one or more of the above and enable you to get on with your life.
We have a track record in CES medical negligence compensation claims for clients who have suffered from CES that was caused by medical negligence. In fact, we have built a solid reputation as cauda equina syndrome claims specialists. Our knowledgebase, as well as our highly professional approach, have made a big difference in the lives of our clients. We have not only acquired compensation settlements, allowing them to start rebuilding their lives, but we also functioned as 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 proper CES medical negligence compensation. So, 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 call one our CES experts at 01204 540 880 now.