How Urgent is Surgery for Cauda Equina Syndrome?

The timing of surgery for cauda equina syndrome has been an issue of debate regarding the urgency of surgery in relation to the quality of the outcome and the nature of the patient’s symptoms.

The focus of debate

The questions of interest regarding surgery for cauda equina syndrome are:

• Is surgery an emergency both for incomplete and complete cauda equina syndrome?
• What will be the effect of a delay in surgery for cauda equina syndrome?
• What is the appropriate timing for decompression surgery for cauda equina syndrome?
• Will surgery bring about recovery of lost function?

The key factor in determining the answers to these questions seems to be extent of the patient’s symptoms at the time surgery is carried out.

In a nutshell

• There appears to be general agreement that the sooner surgery is carried out after the onset of symptoms, the better the outcome is likely to be
• The deterioration of urinary symptoms seems to be an important indicator for the success and urgency of surgery – whilst the patient still retains some control and awareness of bladder function, surgery is both more urgent and more likely to be successful in restoring function
• There seems widespread agreement that surgery as soon as possible but definitely within 24 hours is ideal. A delay beyond 48 hours can lead to a detrimental outcome.
• Timely surgery may lead to recovery of function if the patient has not already lost control of their bladder
• Delayed surgery may mean no recovery is possible

The key to surgery

Before decompression surgery for cauda equina syndrome can take place, there needs to be a definite diagnosis of the cause of the patient’s symptoms. This requires an MRI scan and medical professionals faced with a patient with the early signs of this appalling condition should ensure that an emergency MRI scan is undertaken.

Medical negligence

If a patient has been diagnosed with incomplete cauda equina syndrome, but delays in undertaking surgery mean that the patient’s symptoms deteriorate to ‘complete’ and the opportunity for recovery is lost, the relevant medical practitioners may be considered to have acted negligently.

If symptoms of cauda equina syndrome are not recognised as such and an MRI scan is consequently delayed leading to a poor outcome, again the responsible medical professional may have acted negligently.

Legal Advice

If you or a loved one are suffering with the effects of cauda equina syndrome due to a delay in diagnosis or treatment, you may be entitled to make a claim for compensation. Contact us to discuss your experience with a specialist medical negligence solicitor.

Please call us free on 0800 234 3300, from a mobile click to call 01275 334030 or complete our Free Online Enquiry for a no cost, no obligation opinion.

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