Written by

Iain Dodd - Partner, Senior Solicitor

Cauda Equina Syndrome is a condition that causes the nerves in the lower back to become severely compressed. It is a very rare condition but when it occurs, if it is missed, it can have an extremely catastrophic outcome for the patient. In this guide, we will be discussing Cauda Equina Syndrome and why it is important to spot the signs early.


What is Cauda Equina Syndrome?

Cauda Equina Syndrome is a rare condition but it is extremely serious. It is a condition that affects the nerve routes at the bottom of the spinal cord. The Cauda Equina controls the function of the bladder, the bowel and the sensation to the skin of the genitals and bottom area. The primary function of the Cauda Equina is to send and receive messages between the lower limbs and the pelvic organs. The bundle of nerves that are called the Cauda Equina are at the bottom of the spine and when you have Cauda Equina Syndrome, this bundle of nerves become severely compressed, this causes compromise to the bladder and the bowel. Around one to three in every 100,000 people are diagnosed with Cauda Equina Syndrome.

Cauda Equina Syndrome can progress rapidly and it is a very serious condition that can cause patients significant disability. It is extremely important that patients receive treatment quickly in order to avoid serious damage. 


Cauda Equina Syndrome Symptoms (Red Flags)

Cauda Equina Syndrome can cause many symptoms, sometimes known as red flags, these can have different levels of severity which will depend on the degree of compression of the nerves. Patients that have Cauda Equina Syndrome may have some or all of these symptoms:

  • Urinary retention
  • Weakness or numbness in both legs 
  • Alteration in bowel function
  • Sexual dysfunction 

If you have any of these symptoms, then it could be possible that you have Cauda Equina Syndrome. This condition requires urgent medical care because if it goes untreated for a long period of time then there is a greater chance that it could lead to permanent paralysis and incontinence. There is a critical time window in which you can intervene in order to preserve the bladder, bowel and sexual function. If it is left too long then the odds of a full recovery are significantly reduced. It is therefore important that if you spot any of these red flags, you seek medical attention straight away. 


Causes of Cauda Equina Syndrome 

Cauda Equina Syndrome is commonly caused by a herniated disc in the lumbar region. Many disc herniations do not have an identifiable cause but they can be caused by injuries or strains. 

Potential Causes of Cauda Equina Syndrome

  • Spinal tumours 
  • Spinal Infections 
  • Injuries to the lower back 
  • Birth abnormalities 
  • Spinal haemorrhages 
  • Spinal anaesthesia 


Treatment of Cauda Equina Syndrome 

If someone has any of the symptoms of Cauda Equina Syndrome, they should go to their GP to be examined and if their GP recognises any of the red flags, they should refer the patient to the hospital for further investigation. 

If a patient is diagnosed with Cauda Equina Syndrome, surgery is usually the best treatment for the patient. The ultimate goal of the surgery will be to free up the compressed nerve roots in order to give them the best chance of recovery. If it is left untreated, Cauda Equina Syndrome can result in the patient becoming permanently paralysed. Treating the patient within the first 48 hours of symptoms will provide the best outcome for improving the sensory and motor deficits and urinary and rectal function. 


Importance of spotting the symptoms of Cauda Equina Syndrome 

Cauda Equina is an extremely serious and disabling condition. If this condition is diagnosed and treated quickly then patients are able to make a good recovery. If the diagnosis is delayed, this means that treatment will also be delayed and can cause patients significant harm. When diagnosing Cauda Equina Syndrome, the key is to look for any red flags that the patient is displaying and then arranging for further investigation and treatment. 

NHS Resolution received 827 claims for incidents of Cauda Equina Syndrome from January 2008 to December 2018. Out of these claims, 340 were settled with damages, 212 were without merit and 275 remain open. These claims cost the NHS £186,134,049. 

The main causes of claims referring to Cauda Equina Syndrome are related to delays in: 

  • Diagnosing/recognising symptoms 
  • Responding to red flag symptoms 
  • Surgical intervention 
  • Transport to hospital 

If Cauda Equina Syndrome is not caught and treated at an early stage, it can cause life changing injuries. If you feel that you have had a delayed diagnosis of Cauda Equina Syndrome then you could be entitled to claim compensation. At Patient Claim Line, we have medical negligence experts that you can talk to to discuss your Cauda Equina Syndrome claim.

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