Low back pain is exceedingly common and in the vast majority of case it clears up on its own without treatment. However, occasionally it can be more serious. At the upper lumbar region of the spinal canal the nerves of the pelvis and legs branch out from the end of the spinal chord in a “horse’s tail” effect. Anything that causes a narrowing of the spinal canal at this level resulting in a compression of this particular bundle of nerves is known as Caudia Equina Syndrome (CES).
These nerves are particularly susceptible to injury, particularly those supplying the bladder and bowel, and the most usual cause of CES is a prolapsed (slipped) disc. Other causes include –
- Injury (not necessarily major injury)
- Inflammation
- Tumour
- Infection (particularly abscess)
- Severe bony disease of the spine
- Spinal Anaesthesia
- Congenital abnormality of the spine
Symptoms of CES
- Low back pain
- Acute or chronic radiating pain
- Numbness and/or weakness in legs
- Numbness in perineal area
- Bowel and/or bladder dysfunction
- Sexual dysfunction
Cauda Equina Syndrome can be difficult to diagnose because symptoms vary in intensity and sometimes evolve slowly over time, however surgical intervention is often necessary to avoid permanent nerve damage.
Compensation for mishandled cases of CES is often considerable and results from –
- Failure to diagnose
- Failure to treat
- Inadequate or negligent surgery
- Failure to recognise post-op complications
Cauda Equina Syndrome Clinical Negligence Case
AS, a 35-year-old woman with long standing back pain attended the hospital complaining of a sudden increase in pain radiating into both legs. She also had pins and needles and spasms in both legs. An X-ray and a neurological examination showed nothing of note and she was referred to a physiotherapist.
The physiotherapist referred her back to her GP as she was so concerned about AS’s obvious neurological signs. AS was admitted to hospital and placed on bed rest followed by an unsuccessful trial of spinal traction. Her leg spasms continued and 4 weeks after admission she lost control of her bladder.
A neurosurgeon decided that her symptoms were probably emotional in origin and it was not until more than 3 months after her symptoms began that she had an MRI scan which showed a very large prolapsed disc compressing the spine.
Despite surgery AS is now paraplegic and doubly incontinent and will be confined to a wheel chair and dependent on others for the rest of her life. She has 3 young children. The case was settled for a large sum with the assistance of one of JMW’s expert Clinical Negligence solicitors
JMW Medical Negligence Solicitors offer free initial advice on clinical and medical negligence claims, evaluating whether you have a case. We are able to deal with cases using public funding (formerly Legal Aid) or No Win No Fee in appropriate cases.
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