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Cauda Equina Syndrome: Prognosis For Recovery

Cauda equina syndrome is a rare but serious condition. Although it will not be fatal, permanent complications will arise if treatment is not provided in time. The prognosis for recovery therefore depends upon how quickly surgical decompression is carried out.

Spinal nerve compression

The cauda equina nerves can be found at the bottom of the spinal cord. They enable function of the pelvic organs and legs, and provide sensation to the saddle area (genitalia, perineum and buttocks). The nerves are very sensitive so any kind of compression will soon result in damage. The nerves can become compressed in a number of ways, including a slipped disc or a spinal tumour.

When the nerves are harmed, function and sensation will start to decrease. When these symptoms arise due to cauda equina compression, a person is said to have cauda equina syndrome. The longer compression continues, the more extensive the injury will be. Within a short space of time, the damage to the nerves will be so severe that the nerve root cells die. These cannot be regenerated, meaning the injury cannot be repaired.

Surgical decompression

It is therefore vital that treatment is provided before the nerves become irrevocably damaged. The nerves have to be decompressed, something which can be achieved with decompression surgery. The underlying cause must also be addressed. For example, if the nerves are being compressed because of an inflammation, medication will be needed to reduce the swelling. Or if there is a spinal tumour, a cancer care plan must be devised.

As long as surgical decompression is performed in the early stages – while the condition is still ‘incomplete’ – a patient stands a good chance of making a recovery. There may be some residual symptoms although usually these will improve with time.

Long-term complications of cauda equina syndrome

However, if treatment is delayed and the condition is allowed to progress to the ‘complete’ stage, decompression surgery will have very little benefit. When the condition is complete, a patient will have painless urinary retention and overflow incontinence. When these symptoms develop, the nerves have suffered extensive damage and treatment will not be effective. Consequently a patient will be left with long-term complications such as bladder dysfunction, partial/total paralysis and the loss of sensation in the saddle area.

If a patient is left with permanent cauda equina complications, questions must be raised as to why decompression surgery was not performed at an earlier stage. If medical error is to blame – for example, doctors could not make an accurate diagnosis – there will be grounds for a medical negligence claim. Get in touch with us to find out more.

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