Nerve Damage and Cauda Equina Syndrome

Cauda equina syndrome is when the nerves at the base of the spine are damaged. This will neurological dysfunction, resulting in a number of physical symptoms for the individual concerned.

Nerves of the pelvic, perineal and anal regions

There is a complex system of nerves located at the base of the spine extending down through the pelvic and peri-anal regions of the body.

For example, the pudendal nerve is derived from the nerve fibres of the second, third and fourth sacral nerves. It enters the pudendal canal and gives off the inferior rectal nerve and then divides into the perineal nerve and the dorsal nerve.

The pelvic splanchnic nerves also arise from the second, third and fourth sacral nerves. They form part of the parasympathetic nerve system.

All of these nerves have different functions:

• Inferior rectal nerve: sensation/function in the external anal sphincter, lining of the lower part of the anal canal and the skin around the anus
• Perineal nerve: sensation/function in the skin of the scrotum or labia majus, muscles for penile erection and the external anal sphincter
• Dorsal nerve: sensation/function in the glans penis or clitoris
• Parasympathetic system: sensation/function in the rectum, colon, bladder and sphincter in the bladder

Nerve damage and cauda equina syndrome

Cauda equina syndrome is when something compresses the sacral nerve roots two, three and four, causing them to suffer harm. When damaged, the complex network of nerves will not work properly and function and sensation will be reduced.

This will lead to physical symptoms, including:

• Altered sensation in the perineal and perianal regions
• Dysfunction of bladder control with loss of pain due to over distension of the bladder and poor voiding
• Loss of anal tone

Cauda equina syndrome is also often associated with lower back pain which can radiate down into the buttocks and legs.

Can nerve function be recovered?

The nerves are incredibly delicate and it will not take long for serious injury to occur. Therefore nerve function can only be recovered if treatment is given quickly. If compression lasts for more than 48 hours, the nerves may be so damaged that treatment will not be wholly successful.

If there is a delay in treating cauda equina syndrome and permanent nerve damage does arise, questions must be raised as to the level of care afforded to the patient. If delays were due to medical error or a lack of urgency, there will be grounds for a compensation claim. Contact us to find out more.

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