Slipped Disc and Cauda Equina Syndrome

Cauda Equina Syndrome is a serious condition that can be caused in a number of ways, one of which is a slipped disc. Prompt surgical review is vital in such cases, as emergency treatment to decompress the spine is the only way to protect a patient against long-term health complications.

How does a slipped disc cause cauda equina syndrome?

The spine is made up 24 vertebrae, between each of which sits an intervertebral disc. These discs, which are made up of a strong outer tissue and a softer gel-like middle, are designed to act as a shock absorber, keep the vertebrae separate and allow spinal flexibility.

If, however, there is a weakness in the outer shell, the gel-like middle will protrude through the connective tissue. This is called a slipped disc (or a prolapsed or herniated disc) and is something commonly associated with the ageing process, as well as any activities or accidents that put strain upon the spine.

If a disc slips in the lower back (known as the lumbar vertebrae) it is possible pressure will be put upon the bundle of root nerves located at the bottom of the spinal cord. As compression continues the nerves will become increasingly damaged, in turn leading to a condition called Cauda Equina Syndrome (CES). This is characterised by symptoms such as:-

Lower back pain;
Numbness in the groin;
Bladder and bowel disturbances;
Sexual dysfunction;
Poor anal tone.

Treating a slipped disc and cauda equina syndrome

A patient who is showing signs of CES should be referred for an urgent MRI scan. An imaging test such as this should enable medical professionals to identify whether or not the root nerves and being compressed and if so, what the underlying cause is. If a slipped disc is to blame, medical professionals must arrange emergency surgery to remove the disc, thereby decompressing the nerves.

It is essential surgical intervention is provided as soon as possible, as there is only a small window of opportunity in which treatment will be successful. This is because compression will quickly lead to extensive nerve damage; if this continues for more than 48 hours, it is likely the injury will be irreparable. This will leave a patient with long-term neurological complications, including urinary incontinence, bowel disturbances and even paralysis.

Does a delay amount to medical negligence?

If there is a set-back in treating a slipped lumbar disc, in turn causing acute Cauda Equina Syndrome, it is necessary to discover why a delay occurred. If it can be attributed to the actions or inactions of medical professionals, there could be a case of medical negligence. For example, if doctors fail to recognise the symptoms of CES, fail to carry out diagnostic tests or fail to arrange emergency surgery, the standard of medical care provided will be considered unacceptable. If so, the injured patient will be able to claim compensation for the pain and suffering caused.

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