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Degenerative Lumbar Disc and Cauda Equina Compression

Degenerative changes in the spine can lead to a rare neurological condition called cauda equina syndrome.

Herniated lumbar disc due to degenerative changes

In between each vertebra is an intervertebral disc. These prevent the vertebrae from rubbing together and help to absorb shock. Intervertebral discs can become worn with age, creating degenerative changes in the back. This leads to the back pain that 70 to 80% of the population experience at some point in their lives.

Degenerative discs also have an increased propensity to slip, or herniate. This is particularly prevalent in the lumbar region (the lower back). If the disc does not press upon any surrounding nerves, there will be very few symptoms. But if the protruding part of the disc or the inflamed tissue is pressing upon adjacent nerves, problems will arise.

Most patients with a herniated disc will experience back pain, sciatica, and pins and needles. Normally these symptoms will ease without the need for an operation. The body has its own capacity for healing, and in conjunction with physiotherapy, anti-inflammatory medication and occasionally injections, the pain should subside.

However, on occasions the pain will persist for a matter of months. A patient may therefore be advised that an operation is needed to remove part of the disc to take pressure off the nerve.

Cauda equina syndrome

Around 2% of patients with a herniated lumbar disc will develop cauda equina syndrome as a result of the prolapse. This happens when the prolapse presses upon the bundle of nerves located at the bottom of the spinal cord, called the cauda equina. Cauda equina compression usually results from a large central disc prolapse in the lowest two discs in the lumbar spine (L4/5 or L5/S1).

Within the cauda equina are nerves that control the bladder, bowel and genital sensation. Cauda equina compression will consequently lead to symptoms such as urinary incontinence, erectile dysfunction, reduced sensation in the saddle region and faecal leakage/incontinence.

If these symptoms are to be cured, urgent decompression surgery must be carried out. Therefore medical practitioners cannot wait to see what happens, as would be the case with a ‘normal’ herniated disc. Instead, they must recognise that part of the disc is pressing upon the cauda equina and order emergency surgery.

Failure to treat cauda equina syndrome

If you have had a herniated disc – from degenerative changes or other reasons – and you have developed cauda equina syndrome, you must consider the level of care you received. If medical errors caused you to suffer permanent neurological damage, you could be entitled to pursue a compensation claim. Contact us today to find out more.

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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