When something such as a slipped disc or a spinal tumour places pressure upon the cauda equina nerves, the flow of blood will be obstructed, starving the nerves of oxygen. This is known medically as ‘ischaemia’.
If a nerve fibre becoming ischaemic for too long, it will cause the death of the cell body. The nerve fibres will then be unable to regenerate, meaning normal function will be lost forever. This will leave someone with permanent bladder, bowel and sexual dysfunction.
Urgent treatment of cauda equina syndrome
It is therefore essential for treatment to be provided before the condition becomes complete, as this is when the cell body dies, leaving a patient with painless urinary retention and long-term complications. To avoid this devastating consequence, decompression surgery must be performed when the condition is incomplete, meaning compression has not yet caused total failure of the autonomic innervation to the bladder.
When cauda equina syndrome is incomplete, a patient will have any combination of altered urinary sensation, loss of desire to void, poor urinary stream and a need to strain in order to micturate. However, the condition will not remain incomplete for very long. Some experts suggest the condition will progress to the complete stages within 48 hours of the onset of symptoms. This means there is a very small window of opportunity in which treatment will prove effective.
That is why medical professionals must act with haste if there is any suspicion that a patient has cauda equina syndrome. Doctors should know the symptoms classically associated with spinal nerve compression, such as altered perineal sensation, poor rectal tone and bladder dysfunction. Any patient who presents with these problems must be reviewed by orthopaedic staff at the nearest hospital. This must be a same-day referral.
In hospital, a thorough examination should be performed upon any patient who is suffering the symptoms of cauda equina syndrome, regardless of whether they have attended hospital of their own accord or have been referred by their GP. If the symptoms and test results correspond with nerve compression, an urgent MRI scan must be carried out. If the suspected diagnosis is confirmed, emergency surgery must be arranged as this will prevent any further decline in lower limb sensory or motor deficit.
Failure to refer a patient for cauda equina syndrome
If a GP fails to make a same-day referral for a patient displaying the symptoms of cauda equina syndrome, or medical staff in hospital fail to perform further investigative tests, there will be a case of medical negligence. If this has happened to you and it has ruined your prospects of recovery, you will be entitled to compensation. Contact us at the Cauda Equina Solicitors to find out more.