Urgent Referral for Cauda Equina Syndrome

If a patient is suspected of having cauda equina syndrome, an urgent referral must be made. Any delay in treatment could result in the patient suffering long-term neurological complications.

Symptoms of cauda equina syndrome

Cauda equina syndrome is when the cauda equina nerves at the bottom of the spinal cord are compressed. This might be due to a slipped disc, the narrowing of the spinal canal (stenosis) or a spinal tumour.

However the nerves are compressed, the result will be the same – namely that the nerves will become injured and begin to lose function. This will cause the onset of neurological dysfunction, leading to symptoms such as:

• Lower back pain
• Sciatica in one or both legs
• Foot drop
• Numbness in the buttocks, genitalia and perineum
• Urinary/bowel/sexual dysfunction

Recognising the symptoms of CES

The description of symptoms, initially low back pain and sciatica, followed by the onset of saddle plus genital sensory reduction, and urinary disturbance, suggests compression of the lower sacral roots of the cauda equina.

Any clinician receiving this information from a patient, and understanding the relevance of such history, would record a provisional diagnosis of incomplete cauda equina syndrome (CES-I), and act according to the protocol and care pathway existing in their healthcare organisation.

Treating cauda equina syndrome urgently

The exact route a patient takes to receive treatment will of course depend upon the treating clinician. For example, if a patient is under the care of a physiotherapist, a referral should be made to the hospital along with a clinic letter. If a patient has attended A&E, the surgical team and radiographers must be consulted.

Either way, whatever type of medical practitioner is treating a patient, he/she should appreciate that there are sufficient grounds for arranging an urgent MRI scan, or at least an urgent referral to a spinal surgeon. The term ‘urgent referral’ is of the utmost important here, as cauda equina syndrome must be treated without delay, otherwise the nerves will be irreparably damaged.

Failure to make an urgent referral

If a patient is not urgently referred for an MRI scan, the standard of care must be called into question. If the level of care falls below what would be reasonably expected of a medical practitioner, it will constitute a breach of duty. If this causes a patient to suffer unnecessary harm – i.e. long-term cauda equina complications – there will be grounds for a medical negligence claim.

For more information about claiming compensation for cauda equina syndrome, please get in touch with us today.

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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