Cauda equina syndrome is a condition in which the nerves at the bottom of the spinal cord become compressed, usually due to a prolapsed disc, although other causes are possible.
Stages of cauda equina syndrome
Cauda equina syndrome has now been sub-divided into three types, namely:
- A rapid onset, without previous history of back problems
- Acute bladder dysfunction and patients presenting with bladder dysfunction on a background of back pain and sciatica
- Chronic back pain and sciatica with a gradually progressing cauda equina syndrome
To confuse matter further, cauda equina syndrome is then sub-divided into incomplete (the early stages) and complete (the later stages).
With incomplete cauda equina syndrome (CES-I), the patient may have some urinary difficulties including loss of urinary sensation, as well as some sensory deficit in the perineum and when urinating. This happens because the nerves that serve the bladder and genitalia are being compressed. This damages the nerves, causing them to lose function, in turn resulting in these neurological symptoms.
As pressure continues to be placed upon the nerves, the damage will become more and more extensive until eventually the nerves cells die. A patient’s symptoms will deteriorate until he or she reaches complete cauda equina syndrome (CES-R). This is characterised by painless urinary retention, meaning the patient has no sensation in their bladder and cannot control the flow of urine whatsoever. Normally a patient will then suffer overflow incontinence, whereby their bladder fills to maximum capacity (because the need to void is not experienced), after which the bladder will overflow and there will be an episode of incontinence.
The need to treat CES while it is still incomplete
There is now a general agreement that by the time a patient has complete cauda equina syndrome, the timing of surgery is probably not critical, as irreparable damage is probably done within six hours of compression taking place. However, this time frame will not be true of every case, particularly if there is a slow onset of the condition. Either way, patients with incomplete CES are best treated with early surgery, as this is more likely to have a favourable outcome. If the condition is allowed to progress to the complete stage, a patient will suffer long-term complications.
Did doctors fail to treat your cauda equina syndrome in time?
If medical professionals failed to treat your condition while it was in the incomplete stage, you could be entitled to compensation for the pain and suffering this delay has caused you. Contact us at the Cauda Equina Solicitors to find out more about claiming for cauda equina medical negligence.