Cauda Equina Syndrome

Cauda equina syndrome is a rare disorder that usually is a surgical emergency.

At about the level of the waist, the spinal cord splits into a number of smaller nerve roots called cauda equina (Latin for horse’s tail as it has the appearance of a horse’s tail). They send and receive messages to and from your legs, feet, and pelvic organs.

Cauda Equine Syndrome is caused by something compressing the nerve roots below the level of the spinal cord.

If untreated, the condition will eventually cause complete paralysis below the waist.

Cauda Equine Syndrome generally requires urgent surgical treatment. The longer the compression continues, the more likely there is to be long term neurological damage. Studies suggest that in 50% of cases it will be too late after the first 4 to 6 hours of a severe central disc prolapse resulting in complete Cauda Equine Syndrome. In those cases there is only a very small window of opportunity in which to refer a patient to hospital, confirm the diagnosis by MRI scan and then carry out a surgical decompression.

Symptoms Of Cauda Equina

The symptoms of Cauda Equine Syndrome include:-

• Severe Low back pain
• Pain in one leg or both legs but starts in the buttocks and travels down the back of the thighs and legs (sometimes called saddle anaesthesia)
• Numbness in the groin
• Problems with the Bowel or bladder disturbance such as difficulty passing urine or faeces or incontinence.
• Pain, numbness, or weakness in one or both legs for example that causes you to stumble or have trouble getting up from a chair.
• Reduced or absent reflexes in the lower extremities
• Sexual dysfunction that comes on suddenly

The condition can arise gradually, over the course of several months, or very suddenly, over the space of a few hours. Most commonly, cauda equina syndrome arises and progresses over the course of a few days or a couple of weeks.

Causes of Cauda Equina Syndrome

Causes include

• Traumatic injury;
• Slipped or prolapsed discs;
• Spinal stenosis (narrowing of the spinal canal);
• Spinal tumours;
• Inflammatory conditions;
• Infectious conditions;
• A birth defect such as an abnormal connection between blood vessels
• As a result of medical treatment such as surgery.

Medical Negligence

If you have suffered Cauda Equina Syndrome as a result of negligent medical treatment then you may have a claim for compensation.

Recognition of Cauda Equine Syndrome is often delayed. It is important for medical professionals to document the nature and timing of bladder, bowel and sexual symptoms particularly if they are new and especially in those with a history of back pain and associated leg pain and to make a timely referral for proper investigation and expert treatment.

The common causes of delay in diagnosing and treating Cauda Equine Syndrome are:-

• GPs not recognising the ‘red flag’ symptoms;
• Junior accident and emergency staff failing to recognise the symptoms or misdiagnosing the condition;
• Junior accident and emergency staff not calling for a consultant;
• Delays in arranging MRI scans and surgery within an appropriate period and conducted by a suitably experienced team;
• Misinterpreting scans
• Surgeons and nurses failing to spot signs of the condition following spinal surgery.

 

The amount of compensation awarded in successful compensation cases for cauda equina syndrome claims varies very widely and is particularly dependent on how much better the outcome would have been without the negligence.

 

If the evidence is that the patient would have suffered similar symptoms in any event even without the negligent treatment then the claim may be worth nothing or very little.

 

If however the patient’s outcome would have been much better in the long-term and a near full recovery would probably have occurred but for the negligent treatment and the patient has been left incontinent and unable to walk, the level of compensation can be very high indeed. Compensation in such circumstances will often include amounts for care and support, mobility aids, transportation costs and the cost of adapted accommodation.

OTHER LOSSES

You may also be able to claim for other losses you may have incurred or may incur in the future as a result of the negligent treatment.

This may include:

•  the cost of treatment or medication
•  loss of earnings
•  travel expenses to and from your Hospital for treatment
•  care and assistance someone has had to give you because of your injuries

Keep a record of any financial losses you have suffered as a result of negligence. This will include for example any wage slips or P60s. You should also keep any receipts for other losses.

TIME LIMITS

There are Time Limits for bringing claims of this type…

You only have 3 years to issue Court Proceedings from the date you first knew, or could reasonably have been expected to know, that you have suffered an injury caused by the fault of a medical practitioner .

This could be the date of the mistake or some time later if you did not know you had been injured at the time the mistake was made.

If Court Proceedings are not issued within 3 years of that date you would usually be unable to pursue your claim further.

The Courts can however waive this 3-year time limit in some circumstances. In any event you should seek legal advice at the earliest opportunity.