If left untreated, cauda equina syndrome will progress from the incomplete stage to the complete stage.
Incomplete and complete CES
Incomplete cauda equina syndrome is often abbreviated to CES-I. It is the first stage of cauda equina syndrome, a condition in which the nerves at the end of the spinal cord are compressed. With CES-I, a degree of bladder function is retained.
If the nerves are not surgically decompressed, a patient’s symptoms will get gradually worse until there is a complete loss of bladder function. Once this happens, a patient has complete cauda equina syndrome. This is often abbreviated to CES-R, with the ‘r’ standing for ‘retention’.
How quickly will CES-R develop?
Since there are no published observations studies, it is impossible to reliably estimate the rate of neurological deterioration in CES-I – i.e. how fast deterioration occurs in a patient with incomplete cauda equina syndrome. Nor are there any studies that tell us the proportion of patients with CES-I which progress to CES-R.
In terms of timing, some patients seem to progress rapidly (within 24 hours) from CES-I to CES-R, while in others the rate of progression is slower (over a matter of days). However, it is likely that most patients will with CES-I will progress to CES-R in time, should treatment not be provided.
Timing of treatment
Because a patient can progress from incomplete to complete cauda equina syndrome so quickly, it is vital that treatment is provided as a matter of urgency.
This is especially true if a patient presents to a healthcare setting while still in the incomplete stage, as he/she stands a good chance of making a full recovery if treatment is provided. The prognosis is more uncertain for those patients who present in the complete stage, as the nerves are often irreparably damaged and function cannot be restored.
Therefore a patient with incomplete cauda equina syndrome should be operated upon immediately. A patient should be treated as a surgical emergency. Any delay could see a patient deteriorate from incomplete CES to complete CES, meaning he/she is left with permanent neurological injuries.
Negligent delay in treatment
If surgical treatment is delayed due to medical error, and this causes a patient to progress complete cauda equina syndrome, there may be grounds for a medical negligence claim. Such claims often arise due because doctors fail to make a timely diagnosis, and/or fail to proceed straight to theatre once a diagnosis has been made.
To find out if you can claim compensation for cauda equina syndrome, please get in touch with us today.