Cauda Equina Syndrome (CES)

What is Cauda Equina Syndrome?

The cauda equina (so-called due to its resemblance to a horse’s tail) is located around the waist.  It is a group of nerve roots at the end of the spinal cord and its supply of nerves allows movement of the legs and sensation in the bottom and bladder.

CES occurs when these nerves suddenly become severely compressed perhaps by a herniated disc, a tumour, an infection, a fracture or a narrowing of the spinal canal.

It is estimated that cauda equina syndrome (CES) affects just 1-3 people in 100,000 in the UK.  However, if left undiagnosed and untreated, the consequences can be permanently life-changing, perhaps resulting in paralysis, incontinence, lack of sexual function, and significant psychological repercussions.

Surgery within 48 hours of symptoms

Anyone experiencing any of the Red Flag symptoms listed below should attend A&E immediately. An MRI scan should be carried out within 24 hours so that, if diagnosed, emergency surgery may be performed within 24-48 hours of the onset of symptoms.

The 48-hour time frame gives a patient presenting with cauda equina syndrome the best possible chance of preventing permanent damage.

What are the “Red Flag” Symptoms?

SSaddle AnaesthesiaLoss of feeling around the buttocks, back passage and genitals
e.g you may notice an altered feeling when using toilet paper or a change in sexual function.
PPainSevere nerve pain in back and/or down one or both legs:
this can be similar in sensation to sciatica.
IIncontinenceBladder or Bowel incontinence or difficulty going to the toilet
e.g you may experience a sudden lack of control and/or a loss of sensation.
Alternatively, you may feel like you have a full bladder but may not “be able to go” or you may have no idea if your bladder/bowel is empty or full.
NNumbnessLack of sensation or weakness in both legs that is severe or getting worse
This may also present as pins and needles and affect the inner thighs and/or genitals and back passage.
EEmergencyContact your A&E department immediately if you are experiencing the above symptoms
You may have Cauda Equina Syndrome.
For the best possible outcome, surgery must be performed within 48 hours of onset of symptoms.

What if diagnosis or treatment is delayed?

Beyond 48 hours, the chances of a positive outcome following surgery are significantly reduced, as the damage is likely to be irreparable.

The Clinical Negligence team at Jobling Gowler Solicitors have particular experience with Cauda Equina claims. In a recent case, they successfully represented a lady who suffered from this syndrome when she was in her early 50s.  The hospital she attended failed to note and respond quickly enough when she presented with a history of back pain and multiple red flag symptoms. This caused a delay in both the MRI scan and the emergency surgery which occurred outside the recommended 48-hour window.

As a result, our client suffered a significant permanent disability. She now uses a wheelchair when outdoors and her quality of life has also been severely impacted due to issues with bladder, bowel and sexual function.

We were able to settle the case for a substantial amount, without the need for a court hearing. We also ensured that all aspects of our client’s future well-being were considered, such as aids, equipment, accommodation alterations and also care services and physical and psychological therapies to help improve her quality of life.

If you or a loved one has suffered from Cauda Equina Syndrome – or another condition – due to misdiagnosis or unnecessary delays in treatment in the last 3 years, please do get in touch with us to discuss your particular situation and to assess whether you may be able to make a claim.

At Jobling Gowler, we care about our clients.  We understand that the litigation process can be daunting, so we will provide sensitive support throughout and do our utmost to bring a claim to a successful conclusion.

Call our office on 01625 614 250 to speak to one of our friendly, approachable experts.