Timing of Surgery in Cauda Equina Syndrome

Compensation claims related to cauda equina syndrome inevitably relate to the timing of decompression surgery or a delay in diagnosis which might have led to late surgery. Why does this matter?

Why is surgery necessary in cauda equina syndrome?

Cauda equina syndrome is caused by compression of the cauda equina nerves at the base of the spine. This can be caused by a variety of medical conditions such as spinal stenosis or a tumour but is most frequently caused by a herniated disc impacting on the nerves.

The problem this causes is a reduction in function of the cauda equina nerves. Given that these nerves control the passing of messages of sensation and movement between the brain and the lower body, any loss of nerve function can cause significant problems such as incontinence.

If compression of the nerves is identified as the cause of such problems, then decompression of those nerves is likely to be the best solution.

Why timing matters

It is widely accepted that the timing of surgery in cauda equina syndrome can have a significant impact on the level of function recovered after the operation.

There are two different but related aspects to this:

1) Decompression surgery seems to be most successful in bringing about the most recovery of lost function when it is carried out before the patient loses bladder sensation. Once the patient is experiencing painless retention of urine, their chances of a good outcome would appear to be diminished.

Alteration in sensation of urination, such as poof flow or having to strain, is a red flag symptom of cauda equina syndrome and, if associated with other symptoms, should prompt an emergency MRI scan to assess the cause.

2) Once a diagnosis is achieved, timing continues to be of the essence. If the patient still retains some urinary control and awareness, it is thought that surgery should be undertaken within hours and as a matter of emergency. A delay in surgery may provide sufficient time for the patient’s condition to deteriorate to the point where surgery may be less successful.

Delays in diagnosis and surgery

It is clear, therefore, that an early diagnosis and emergency surgery can be crucial to the long-term well-being of the patient who is developing this dreadful condition.

A failure to recognise early symptoms of cauda equina syndrome may result in a delayed confirmation of the underlying cause, during which time the patient may deteriorate.

A failure to arrange emergency surgery once a diagnosis of incomplete cauda equina syndrome has been made may also lead to deterioration of symptoms.

Medical negligence

In both of the above circumstances, the relevant medical practitioner may be considered to have acted negligently. Where the patient is, as a result, left with the appalling long-term symptoms of cauda equina syndrome, a claim for compensation may be an appropriate course of action.

If you are suffering with the debilitating and life-changing effects of complete cauda equina syndrome due to a delay in your treatment, contact us to discuss your situation 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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