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What is the Prognosis for Cauda Equina Syndrome?

The prognosis for cauda equina syndrome depends upon how quickly decompression surgery is performed. If carried out while the condition is incomplete, the prognosis is favourable. If carried out while the condition is complete, the prognosis becomes more doubtful.

Prognosis for cauda equina syndrome

The prognosis in deteriorating incomplete cauda equina syndrome (CES-I), when treated with urgent decompression, is generally thought to be better than in patients with complete cauda equina syndrome (CES-R). Urgent decompression means that it is performed within 24 hours.

Once urinary retention has developed, the prognosis is worse than when a patient still retains some ability to control their bladder. Because of this, neurosurgeons tend to operate on patients with CES-I as an emergency (meaning within hours, rather than days). The outcome in terms of preservation of bladder, bowel and sexual function is thought to be better in patients who have not yet progressed to a state of cauda equina syndrome with retention.

This theory is supported by a number of medical experts who have analysed cauda equina outcomes. Lavy suggests that if a patient is operated on while he/she has preserved or near preserved bladder function (CES-I), their prognosis from a bladder function perspective is likely to be good. The function of the bowel and sexual organs should also be retained.

If, however, through a delay in decompression surgery a patient with a mild degree of CES-I is allowed to progress to a more advanced degree of CES-I or to a state of CES-R, then their prognosis from a bladder function perspective is likely to be less favourable. It is also likely that there will be other neurological deficits such as bowel and sexual dysfunction.

In summary, the sooner a patient with CES-I is operated on, the greater likelihood that they will retain normal function. When a patient with CES-R undergoes decompression, it is likely he/she will experience a loss of bladder, bowel and sexual function. The degree of dysfunction will vary from patient to patient.

Delay in decompression surgery

If there is a delay in decompression surgery, during which time a patient advances to the complete stage of cauda equina syndrome, it may be that the standard of care fell below an acceptable level.

Medical professionals should be aware that a patient with incomplete cauda equina syndrome required emergency decompression surgery. Any unreasonable delay will be considered negligent. If this causes a patient injury – i.e. he/she develops CES-R – there will be grounds for a claim.

If you suspect you could be entitled to make a claim for cauda equina syndrome, please get in touch with us today.

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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