The success of surgery in curing cauda equina syndrome is a complex area of debate and seems to depend very much on the patient’s condition at the outset of surgery.
Effects of cauda equina syndrome
Cauda equina syndrome, where the cauda equina nerves at the base of the spine have become compressed, can lead to the following appalling, life-long symptoms:
- Loss or urinary sensation and control
- Loss of sexual sensation and function
- Loss of bowel control
- Loss of sensation and motor function in the legs
Recovery from cauda equina syndrome
There is some suggestion that those patients whose cauda equina syndrome has developed gradually are more likely to recover their lost function after surgery than those whose symptoms develop suddenly.
It would also appear that those patients whose neurological loss prior to surgery does not include the complete loss of urinary function (CESi) are more likely to recover lost function or, at least, not to deteriorate still further. Whereas those patients who have completely lost urinary function and sensation before surgery (CESR) are less likely to recover their lost function.
The implication is that the success of surgical decompression to treat cauda equina syndrome is more related to the timing of surgery in relation to the patient’s symptoms than the quality of the surgery itself although, of course, that will also be significant.
Emergency Surgery
In consequence, the most essential aspect of medical management of cauda equina syndrome is the prompt recognition of its symptoms, preferably before they deteriorate, and the referral for an emergency MRI in order to facilitate emergency surgery where appropriate.
It is likely that, once the patient starts to experience loss of sensation and function around the saddle area, they will, over time, deteriorate to greater loss of neurological function.
Therefore, if the symptoms of cauda equina syndrome are not recognised and an MRI is not organised, leading to a delay in surgery, this may allow a deterioration in symptoms to occur before the opportunity arises to improve the situation.
Outcomes of surgery
If a patient does not improve after decompression surgery, it may be that their neurological loss had already developed to the point where it was less likely to recover anyway.
Whether this was due to a late attendance at A&E due to the patient’s delay or whether the delay was due to a failure on the part of the GP or other medical professionals is a key question in determining whether the patient can subsequently make a claim for compensation.
It is also worth pointing out that even the best-timed surgery does not guarantee recovery but it should, at least, prevent further deterioration.
Medical Negligence
If you continue to suffer the devastating effects of cauda equina syndrome because your medical practitioners caused a delay in your diagnosis or surgery, you may be able to claim compensation.
Contact Glynns Solicitors to discuss your experience. We are a medical negligence legal practice, specialising in cauda equina syndrome claims.