If cauda equina syndrome is not diagnosed and treated in time, the patient will be left with chronic cauda equina syndrome. This means that their symptoms will be long-lasting.
A chronic cauda equina syndrome
Cauda equina syndrome must be diagnosed and treated with decompression surgery. This must be achieved within 48 hours of the onset of red flag symptoms. If this care is not provided in time, the patient’s condition will be permanent. This is known as chronic cauda equina syndrome.
Problems associated with chronic CES
Post-surgery the patient will be left with typical symptoms of a chronic cauda equina syndrome.
Consequently the patient may require a large number of medications. There may still be urinary retention and constipation. Stress incontinence of urine may necessitate the use of incontinence pads. If laxatives are used it can result in bowel incontinence.
There may be a lack of sensation around the buttocks, with urinary and sexual function being abnormal. The patient may also describe ongoing weakness and numbness in the lower limbs, affecting their ability to work and carry out domestic activities.
Prognosis
There may be some improvement in the patient’s condition after surgery. This can continue for up to two years after surgery. After two years has passed, the patient’s neurological handicaps are likely to be fixed. The associated disability is also likely to remain unchanged.
These physical complications can lead to significant emotional, social and financial issues. For instance, the patient may become depressed, reluctant to socialise or leave the house, be unable to continue with employment and face difficulties with a spouse or partner.
Avoiding a chronic cauda equina syndrome
The only way to avoid chronic cauda equina syndrome is to carry out decompression surgery before the nerves have become too badly injured. As long as this opportunity is not missed, the patient can achieve a favourable outcome with minimal residual neurological deficits, normal bladder and bowel function, no weakness or persisting neuropathic pain.
Missed opportunities to treat CES
But if opportunities to treat cauda equina syndrome are missed, the patient will progress to complete cauda equina syndrome with urinary retention. By this stage the nerves have become severely injured and decompression surgery will have little effect.
If opportunities to diagnose an early incomplete cauda equina syndrome are missed because of medical mistakes, the standard of care may be deemed unacceptable. If the patient suffers injuries that could otherwise have been avoided, there could be grounds for a claim.
To find out more about cauda equina claims, contact our cauda equina lawyers today.