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Slipped Disc and Cauda Equina Syndrome

Cauda Equina Syndrome (CES) refers to the compression of the nerve roots located below the conical end of the spinal cord. Compression of the nerve roots can happen in a variety of ways, most commonly by a slipped (prolapsed) disc.

Recognising Cauda Equina Syndrome After A Slipped Disc

The nerve roots at the bottom of the spinal cord are responsible for sending motor and sensory signals to the lower half of the body, thereby allowing the lower limbs, pelvic and sexual organs and perineum to function (in terms of movement and/or sensation). When they are compressed by a slipped lumbar disc, a characteristic pattern of neuromuscular, urogenital and rectal symptoms will develop. Although there is no universally accepted definition of the CES, it generally taken to be the presence of lower back pain, sciatica in either one or both legs, saddle anaesthesia, motor weakness in the legs ultimately leading to paraplegia, reduced sensation of bladder fullness, rectal and urinary incontinence and loss of sexual function.

It is important to remember that not all patients who suffer a slipped disc will go on to experience nerve compression. However, a patient who had a prolapsed intervertebral disc with back pain and sciatica who then proceeds to develop urinary and/or rectal symptoms and/or saddle anaesthesia should undergo investigation for Cauda Equina Syndrome. More specifically, these symptoms may include:-

  • Altered urethral sensation;
  • Loss of desire to void;
  • Hesitancy and poor urinary flow;
  • Loss of sensation of bladder fullness;
  • Feeling of retention or incomplete voiding;
  • Need to strain;
  • Perirectal numbness;
  • Loss of rectal control;
  • Sensory abnormalities in the rectum/anal canal;
  • Loss of ability to achieve or maintain an erection;
  • Loss of sensation of orgasm;
  • Saddle anaesthesia.

The development of the above symptoms is an indication for an urgent (ie. within hours) MRI scan to be performed to determine whether or not there is an acute cauda equina compression.

Failure To Detect Cauda Equina Syndrome After Slipped Disc

If medical professionals fail to recognise the typical signs and symptoms associated with Cauda Equina Syndrome, the consequences will be devastating. Within a very short space of time the nerves will suffer extensive damage, rapidly causing a patient's symptoms to deteriorate. If compression persists for more than 48 hours the level of injury will be so severe that it is irreparable. This will result in devastating long-term complications for the individual concerned, who will have to live with a loss of urinary, rectal and sexual function.

If you have suffered a prolapsed disc which resulted in Cauda Equina Syndrome, but this was not detected by medical professionals in a timely fashion, you need to speak to a solicitor. This is because a failure to recognised the typical symptoms of CES and subsequently carry out further investigative tests represents a substandard level of care. Anyone who has suffered because of this negligence will be entitled to claim compensation for the injuries they have sustained.

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