Cauda equina syndrome must be treated with lumbar decompression surgery. This must be performed as soon as possible or the nerves will suffer long-lasting damage.
Lumbar decompression surgery
Lumbar decompression surgery is used to relieve pressure that is being placed upon the lower part of the spine, causing pain and neurological problems. Most commonly this will be a vertebral disc that has slipped and is pressing upon the cauda equina nerves.
If the nerves are compressed, it will lead to a separate condition called cauda equina syndrome in which the cauda nerves are harmed, reducing function and sensation in the bladder, genitalia and legs. The cauda equina nerves can also be compressed due to a spinal injury, a tumour and conditions such as spinal stenosis.
During lumbar decompression surgery, the patient will lie face down on a curved operating table. This better exposes the lower back and reduces pressure on the chest. A general anaesthetic will then be administered. Once a patient is unconscious, the surgeon will open the lower back and assess the spine.
The surgeon will then decide how best to alleviate the compressed nerves. There are three possible techniques that can be used:-
1. A laminectomy, where the lamina (an arch of bone) is removed;
2. A discectomy, where is section of a vertebral disc is removed;
3. A spinal fusion, where two or more vertebra are fused together with a bone graft.
A surgeon may use one, two or all of the aforementioned techniques, depending upon the cause of compression. Whatever method is used, the overall aim is to relieve the pressure being placed upon the spinal cord.
Failing to decompress the nerves
As long as lumbar decompression surgery is provided before the nerves suffer too much damage, the results will be positive. Indeed, it is possible that a patient will go on to make a full recovery and regain normal function.
However, if the nerves are placed under prolonged pressure, the injury will be so deep-set that the nerve root cells die. These cannot regenerate, so even if decompression surgery is subsequently performed, it will not be effective. Consequently a patient’s symptoms will be permanent. The nature of a patient’s long-term complications will vary, but normally include bladder dysfunction, sexual dysfunction and partial/total paralysis.
Making a claim for cauda equina complications
If lumbar decompression surgery is not provided in a timely fashion and medical professionals are to blame for the delay – for example, because they could not reach an accurate diagnosis – there will be a case of medical negligence. The injured individual will therefore be entitled to claim compensation for the pain and suffering that has been caused.