Cauda Equina Syndrome (CES) is a rare and very serious condition. Regardless of how CES occurs, it is vital that any patient is treated as a surgical emergency.
 
Located within your spine are various nerve roots which are responsible for sending and receiving signals or messages to different parts of your body.
 
The area relevant to CES is just above the waist which is approximately where the spinal cord ends. The group of nerves in this region are called the Cauda Equina.
 
The Cauda Equina are responsible for the supply of nerves to the lower limbs, bladder and bowels. They also supply sensation to the skin around the back passage and bottom (otherwise known as the perineal area).
 
CES occurs when the nerves are compressed which can result in an individual suffering from one or more of the red flag signs and symptoms including bladder and bowel dysfunction, saddle anaesthesia, sexual dysfunction and nerve root problems in the lower limbs.

Here of some of the ways CES can occur:

• Large lower lumbar disc herniation – this is usually compression of the discs at the L4/L5 and L5/S1 area. The NHS describes a herniated disc as being a “slipped disc” which occurs “when a soft cushion of tissue between the bones in your spine pushes out”. This is said to be the most common way CES can occur.

• Congenital – a patient may have a congenitally narrow spinal canal (through problems such as spina bifida) or may have acquired spinal stenosis (narrowing of the spaces within your spine).
• Tumours – such as metastases, lymphomas and spinal tumours.
• Trauma resulting in injuries such as fractures.
• Infection – including circumstances where an abscess may form either within the spinal canal or by pressing on the Cauda Equina.
• Post operative complications such as a haematoma. A haematoma is a solid swelling of clotted blood within the tissues. Such a complication can occur following a spinal anaesthetic.

 
The above is not an exhaustive list.
 
Irrespective of how CES occurs, the red flag signs and symptoms of CES remain the same and urgent medical advice and treatment should be sought from your GP or local A&E department.
 
If you are suffering CES, then your clinician should make an urgent referral for further investigations and treatment. 

If you have attended upon a treating clinician displaying symptoms of CES and were not urgently referred to an appropriate clinician or hospital for investigations and treatment, you may be able to make a medical negligence claim for financial compensation.

Our specialist team can offer advice on a no-obligation basis. After having an initial consultation with you, our team will assess whether you may have a potential medical negligence claim.

If you then decide that you would like to proceed with a claim we have a range of funding options available including a No-Win, No-Fee Agreement supported, if appropriate, by legal expenses insurance.

Do not delay – there can be a time limit affecting your right to claim, so contact us now to see if you have a potential medical negligence case.

The onset of Cauda Equina Syndrome may be sudden, within hours or sometimes gradual over weeks or months. No matter how a patient may develop Cauda Equina Syndrome, it is imperative that it is diagnosed and treated as early as possible. Therefore, it is extremely important that patients are referred urgently to appropriate medical professionals who can confirm a diagnosis of CES and provide urgent treatment – usually surgery.

Some medical professionals distinguish different stages of CES as follows:

CES-S
This means CES suspected or suspicious. A patient may show symptoms such as bilateral radiculopathy which may feel like the nerves have been pinched and can result in pain, weakness, numbness, or difficulty controlling specific muscles, particularly the legs.

CES-I
This means CES incomplete. If the CES is incomplete, a patient will generally have urinary difficulties of neurogenic origin including altered urinary sensation, difficulty urinating which could be a poor flow or perhaps feeling like you want to urinate but cannot and loss of feeling that you need to urinate. There may also be loss of sensation in and around the saddle and genital area. 

CES-R
This means CES retention and generally means that the CES is complete. Usually, a patient will have issues including urinary retention without being aware of such a problem as there can often be no pain associated with the retention and complete loss of control of the bladder. A loss of sensation around the saddle and genital area is usually full or extensive at the very least.

It is vital that patients are urgently referred to a suitable medical professional at the CES-S and at the latest, the CES-I stage. The later a patient waits for a referral and subsequent treatment, the worse a patients outcome and recovery is likely to be.

Patients at the CES-S and CES-I stage should be referred urgently for a MRI scan of the spine as this will help to identify whether a patient has CES and the likely cause.

It is vital that the referral is urgent as patients can deteriorate to CES-R rapidly. 

Can I make a medical negligence claim if I have not been urgently referred?

If you have attended upon a treating clinician displaying symptoms of Cauda Equina Syndrome and were not urgently referred to an appropriate clinician or hospital for investigations and treatment, you may be able to
make a medical negligence claim for financial compensation.

Our specialist team can offer advice on a no-obligation basis. After having an initial consultation with you, our team will assess whether you may have a potential medical negligence claim.

If you then decide that you would like to proceed with a claim we have a range of funding options available including a No-Win, No-Fee Agreement supported, if appropriate, by legal expenses insurance.

Do not delay – contact us now to see if you have a potential medical negligence claim.