If a slipped disc results in cauda equina syndrome, emergency surgery will be needed to remove the prolapse. Care must be taken to remove all the disc fragments. If any are retained, the patient must return for further surgery the following day.
A failure to remove any retained disc fragments could amount to a breach in duty. If this causes further injury due to cauda equina compression, there could be grounds for a medical negligence claim.
Decompression surgery for cauda equina syndrome
A disc that prolapses centrally in the L4/5 region can result in a condition called cauda equina syndrome. This is when the cauda equina nerves at the bottom of the spinal cord are compressed and lose function.
When this happens the slipped disc needs to be immediately removed, or the cauda equina nerves will become irreparably damaged. A patient must therefore undergo emergency decompression surgery.
Ongoing compression from retained disc fragment
The patient should be reviewed the day after surgery. If there is no clinical improvement, it is good practice to organise repeat imaging to confirm that the decompression was adequate. A failure to organise an MRI scan will represent a breach in duty.
If post-operative imaging is performed, it may demonstrate ongoing evidence of cauda equina compression, likely arising from a retained disc fragment. If the scan does show ongoing compression, the patient ought to be immediately returned to surgery to allow adequate decompression of the cauda equina.
This early return to theatre will afford the patient a great deal of benefit, as it will prevent further damage of the cauda equina nerves.
Cauda equina complications
If a patient is not reviewed and the retained disc fragment is not detected, further complications could arise.
Even if a patient has already gone into complete urinary retention, there is a chance that timely decompression surgery will lead to some improvement in symptoms. However, if the nerves continue to be compressed by disc fragments, the nerves will continue to suffer harm and the prognosis will be adversely affected.
This may leave a patient with life-changing injuries that could otherwise have been avoided with adequate decompression. This can include loss of mobility, reduced sensation in the perineum and genitals, and bladder and bowel dysfunction.
Medical negligence compensation
If you have been affected by inadequate decompression surgery, please get in touch with us to talk to a solicitor. You could be entitled to claim compensation.