What are CESI and CESR?

Understanding the development of cauda equina syndrome and acting with urgency at the appropriate moment is vital if the patient is to avoid a lifetime of disability.

Cauda equina syndrome development

In some patients, cauda equina syndrome can develop suddenly and acutely and it is possible that surgery may make little difference to the long-term outcome.

In many patients, however, there is a development of the condition over a longer period of time and, in these circumstances, a diagnosis of the condition before it deteriorates from CESI to CESR is vital.

CESI (incomplete cauda equina syndrome)

Some of the key symptoms of cauda equina syndrome are lower back pain, and pain and tingling or numbness in one or both legs. Loss of sensation between the legs is also a key indicator that a patient might be developing this dreadful condition.

In terms of assessing the best moment for surgery, however, it is widely felt that the functioning of the bladder is a key sign of what might be the long-term outcome for the patient.

Changes to and loss of control of the bladder is a fundamental element of cauda equina syndrome. The patient might initially notice that they are experiencing alterations in their bladder function. The flow may change, they may have to strain to urinate and they may have difficulty in emptying their bladder.

The key thing is that the patient still has awareness of the need to urinate and still has some control over that process. This is when the condition is described as ‘incomplete’ or CESI.

It is at this point that surgery is considered to be an emergency and has the greatest chance of leading to a recovery of function by the patient.

CESR (cauda equina syndrome with retention)

If the patient loses awareness and control of the bladder, meaning that they no longer realise that they need to urinate and may be incontinent of urine, it seems that the best moment for surgery may have passed. Decompression of the cauda equina nerves is still likely to be required but there may be a smaller chance of recovery of any lost function – urinary, bowel and sexual.

Medical negligence

If the patient presents to their medical practitioner with the red flag symptoms of CESI but there is a failure to recognise these symptoms and a failure to refer for emergency investigation and treatment, thereby allowing the patient to deteriorate to CESR, the medical practitioner may be considered to have acted negligently.

In this instance, the patient may be able to make a successful claim for compensation for their subsequent pain and suffering.

Legal Advice

If you are suffering with the appalling long-term effects of cauda equina syndrome due to a failure to recognise your early symptoms, contact us to discuss your experience.

We are a specialist medical negligence practice, with years of experience of cauda equina syndrome compensation claims and will be very happy to advise you.

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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