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The spinal cord ends at the level of the first lumbar vertebra and it is at this level that the four sacral nerves and five lumbar nerves emerge and run downwards. These two major groups of nerves are called the cauda equina and are the motor nerves which control movement and sensory nerves which also control the pelvic organs and are vital for the normal bowel, bladder and sexual function. Cauda Equina Syndrome (CES) arises when the nerves are compressed and damaged and is defined by a number of symptoms including low back pain, sciatica, muscle weakness of the legs, sensory disturbance, loss of function of the bladder and bowel and saddle anaesthesia which is numbness or reduced feeling around the area that would sit on a saddle. CES can result when the patient has undergone physical trauma, lumbar disk disease, abscess, spinal anesthesia, tumor, late-stage ankylosing spondilitis, idiopathic causes, inferior vena cava thrombosis, lymphoma or sarcoidosis. If you believe that you have been a victim of CES due to clinical error you should urgently contact a CES solicitor for legal advice on your options to claim compensation.

Medical Negligence

This condition is extremely serious and inadequate treatment can result in severe disability. Cauda equina syndrome medical negligence claims almost inevitably arise because of delayed or inadequate treatment for compression of the nerves in the lower spine or as a result of errors during surgery to relieve back pain or due to delay in treating blood clots after spinal surgery. This condition is generally treated as a medical emergency because delay in treatment can lead to permanent debilitating consequences the most severe of which is paraplegia. Urgent surgical treatment is necessary to restore bladder and bowel function which can also prevent further deterioration of function in the lower extremities.

Prolapsed Disk

The Cauda Equina (meaning 'horses tail') is the bundle of nerves at the base of spinal column that eventually run down the legs and into the lower abdomen to control movement and feeling. Cauda Equina Syndrome is generally caused by a prolapsed disc at the base of the spine which exerts pressure on the network of nerves found at the end of the spinal cord which are responsible for lower-body movement. This condition may also be known amongst medical practitioners by other names, including: variable lower extremity motor and sensory loss, bladder and bowel dysfunction, saddle sensory disturbances, unilateral or bilateral sciatica or may be totally mis-diagnosed and mis-described as lower back pain. If this condition goes untreated, irreparable damage will be done to the nerves; therefore emergency surgery is essential. Compensation claims against medical institutions are usually made when the treating physician has delayed referral to a specialist or when surgery has been carried out negligently creating irreparable damage.

Cauda Equina Syndrome Symptoms

Cauda Equina Syndrome does not cause fatalities but may cause other conditions such as: venus thromboemboli, decubitus ulcers, or bladder infection. There are two basic types of Cauda Equina Syndrome � traumatic Cauda Equina Syndrome (which is not age-specific) and the autraumatic Cauda Equina Syndrome. The latter generally strikes adults because of epidural abscess, metastatic cancer, spinal disc disease or surgical morbidity. The symptoms of Cauda Equina Syndrome include :- pain that is frequently concentrated in the lower back; generally perceived tenderness after palpitation or percussion by the doctor; reflex abnormalities; the hallmark pain in the legs or radiating to the lower limbs; sensory abnormality perceived in the lower extremities or perineal area; muscle weakness (due to effects on nerves controlling those muscles); muscle wasting. Symptoms in chronic Cauda Equina Syndrome include; poor anal sphincter tone; skin breakdown reflected in anaesthetic areas; and changes in bladder function.

CES Medical Emergency

Cauda Equina Syndrome should be dealt with as an emergency case requiring immediate attention. Surgery within 48 hours is the preferred treatment option because it permits lumbar decompression and makes more room for the affected nerves. Early detection means a better chance for the patient to recover fully. If this condition is caused by an infection the patient should be given antibiotics. If caused by a tumour there may be a recommendation of chemotherapy treatment and/or radiation therapy. Treatment that is late due to this condition being initially undiagnosed may not be successful or may only be partially successful and if permanent injury results then there may be a potential medical negligence compensation claim. Physicians should be ready and vigilant to spot the symptoms of Cauda Equina syndrome, where low back pain, pain in the legs, muscle weakness, lack of bladder control, numbness in the 'saddle' area between the legs and incontinence are all sure signs. Delays in referring a possible Cauda Equina syndrome condition to the neurologist wcan leave the patient much damage to the nerve roots.

Medical Negligence Solicitors

If you think you have Cauda Equina Syndrome as a result of medical negligence through non-referral to a specialist or delay in referral or through shoddy surgery, you will need to discuss a potential compensation claim with a CES solicitor. You may be disabled for life as a result of medical negligence due to this condition and you should get the right amount of compensation relating to the pain you have suffered and loss of earning potential. To speak to a Cauda Equina Syndrome solicitor at no cost and without further obligation just call the helpline or complete the contact form or email our solicitors offices.



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The author of the substantive medical writing on this website is Dr. Christine Traxler MD whose biography can be read here