Acting On Signs of Cauda Equina Syndrome

If a patient has the symptoms associated with cauda equina syndrome, a medical practitioner should act immediately. A certain course of events should be initiated, starting with a neurological examination, following with an MRI scan and finally decompression surgery.

Signs and symptoms of cauda equina syndrome

There is a set of symptoms which together suggest cauda equina syndrome. These are:

• Bilateral leg symptoms
• Altered bladder and bowel function
• Loss of sensation in the perineum, anus and saddle area

Neurological examination for cauda equina syndrome

In any patient who has bilateral leg symptoms with a record of altered bladder and bowel function, a detailed assessment of perianal, perineal and saddle sensation should follow. This should include a digital rectal examination. If this cannot be undertaken for any reason, then arrangements need to be made for such an assessment at the local hospital.

Future neurological examination

Only if the results are found to be normal can a clinician exclude a diagnosis of cauda equina syndrome, for the time being at least. If a patient’s symptoms continue or worsen over the following days/months/years, another examination should be conducted.

Indeed, just because a previous examination has not indicated cauda equina syndrome does not mean that the condition will not develop in the future. It is a progressive syndrome and requires close monitoring.

Acting upon signs of cauda equina syndrome

If there are signs of perineal, perianal, altered saddle sensation or altered anal tone, these should be found during an appropriate examination.

Once these signs are detected, a patient should undergo an MRI scan of the lumbar sacral spine on an emergency basis. This will show whether there is a large prolapsed disc at the L4/5 level, or any other source of compression (such as a tumour).

The patient should then be listed for decompression surgery, again on an emergency basis. This means having surgery on the same day, or early the following morning.

Avoiding cauda equina complications

If decompression surgery is performed adequately then, on the balance of probabilities, the patient will be spared all the features of cauda equina syndrome and the complications associated. There may be ongoing episodes of low back pain, but problems such as foot drop, lack of sensation in the lower limbs/perineum/genitals, and bladder/bowel/sexual dysfunction will be avoided.

Failure to act upon cauda equina symptoms

If medical practitioners do not action the process of diagnosing cauda equina syndrome because the symptoms were not recognised, there could be a case of medical negligence.

To find out if you can claim compensation for cauda equina negligence, 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.

Share Article With: