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Cauda Equina Syndrome Surgery Delay

Sarah was driving her car one day when she lost control, causing the vehicle to roll. She did not seek medical assistance but went home. Upon her husband's advice, Sarah attended hospital some days later, where she was diagnosed as suffering from mental shock and discharged.

Over the next couple of months Sarah started to experience severe back pain, leaving her unable to work. She consulted her GP, who diagnosed her with fibromyalgia - a condition that causes pain across the entire body.

Sarah's discomfort continued and the pain began to localise in her leg, lower back, and posterior. She visited her GP who referred her to a Pain Clinic. Sarah told the specialist of her pain, as well as a little strip of numbness along the posterior aspect of the thigh. She was then referred to a physiotherapist.

A couple of days after attending physiotherapy, Sarah reported to her GP with acute back pain and severe spasms which had led to her collapsing on the floor. She was given medication for the spasms.

Sarah returned to her GP just over a week later complaining of numbness between her legs and diminished ability to hold urine for the past two to three days. Sarah's GP advised her to attend hospital immediately, as there was a concern she was developing cauda equina compression, whereby the nerves in the lower section of the spinal canal become compressed.

In casualty, a doctor confirmed Sarah had spinal cord compression, and she was admitted. The next day she underwent an MRI scan, which showed there was a significant amount of urine retained in her bladder, even after she had visited the toilet.

Sarah then had to wait ten days until she was consulted by a surgeon. In the meantime her symptoms deteriorated rapidly. She was suffering paraesthesia (numbness and tingling) in both legs, paraesthesia in her lower back, loss of sensation in the perineal and perianal region, and was unable to move her bowels. Sarah also had the sensation of a full bladder, but was unable to void.

An orthopaedic surgeon eventually reviewed Sarah and decided she did not need surgery. However, upon consulting with other surgeons there was a change of opinion, and Sarah was told she would undergo a discectomy. Consequently, fifteen days after being admitted to hospital, Sarah underwent a lumbar discectomy, during which she suffered a dural tear.

The operation partially relieved her leg pain, but she still experiences a large amount of discomfort. She continues to have numbness in her leg, posterior, and vagina, and has severe back pain. Sarah is unable work, carry out household chores, or enjoy her hobbies. Sarah remains under the care of an urologist, as she has regular bouts of incontinence and must catheterise daily. She also requires laxatives to open her bowels. Unsurprisingly, she has become very depressed.

After discussing her case with Glynns, we instructed a specialist who confirmed that the delay in surgery had left Sarah suffering from cauda equina syndrome. This has resulted in symptoms (including back pain, poor bladder function, the loss of perineal sensation, and weakness in her right leg) that would have improved or disappeared entirely had a delay in treatment not occurred. The breach of duty has meant Sarah's life has been adversely affected, and she was awarded over £90,000 compensation for damages.

(Details which might identify our client have been changed.)

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