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Cauda Equina Decompression

If you have been diagnosed with cauda equina syndrome, you may require decompression surgery as a matter of emergency. Why is this so crucial?

Why?

Cauda equina syndrome is the result of failing function of the cauda equina nerves in the lower back, caused by compression of those nerves. It can develop either gradually or suddenly and it can present with symptoms at varying degrees of severity but, as a general rule, it is thought that early diagnosis and emergency surgery is the best route to a positive outcome and recovery of function.

Where surgery is delayed, the long-term symptoms of cauda equina syndrome can include double incontinence, sexual dysfunction and loss of motor function in the legs. Therefore, a prompt and accurate diagnosis is vital and surgical decompression is key to recovery.

When?

As stated in ‘Standards of Care for Suspected and Confirmed Compressive Cauda Equina Syndrome’ published by the British Association of Spine Surgeons, ‘Nothing is to be gained by delaying surgery and potentially much to be lost. Decompressive surgery should be undertaken at the earliest opportunity, taking into consideration the duration of pre-existing symptoms and the potential for increased morbidity whilst operating in the small hours.’

Emergency decompression is thought to be imperative when a patient with symptoms and evidence of cauda equina syndrome still retains some ability to control their urinary function. If surgery is undertaken at this point, not only should it prevent further deterioration of the nerves and their functioning, but there is a significantly higher chance of recovery of lost function.

It seems to be agreed that surgery within hours is desirable, within 24 hours is preferable to beyond 24 hours and within 48 hours is preferable to beyond 48 hours.

Where decompression surgery is delayed, the outcome for the patient would appear to be less favourable.

However, if the patient has lost control of urinary function, the timing of surgery is thought to be less significant anyway although some recovery may still be possible with prompt surgery.

What?

The cauda equina nerves emerge from the base of the spinal cord in the lumbar region of the back. Compression of the nerves is usually due to a prolapsed or herniated disc pressing on the nerve and the primary aim of surgery is to relieve the compression.

Decompression surgery may involve either a micro-discectomy which removes sections of the herniated disc or a laminectomy which removes the lamina behind the disc and thereby relieves the pressure on the nerve.

Medical Negligence

Decompression surgery in itself is rarely a cause of a compensation claim but a delay leading up to – either in obtaining a diagnosis or arranging surgery itself –might well be.

If you are suffering with the distressing symptoms of cauda equina syndrome due to an unreasonable delay in treatment, contact us at Glynns Solicitors to discuss your case.

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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