Cauda Equina Syndrome Secondary to Lumbar Disc Herniation
Cauda equina syndrome can arise secondary to a lumbar disc herniation. This is effectively when a disc slips in the lower back and presses upon the cauda equina nerves, causing them to suffer damage.
In this article we explore the terms 'lumbar disc herniation' and 'cauda equina syndrome' in more detail, explaining how they are linked. We also look at how the problem should be treated and what might amount to negligent medical care.
Lumbar disc herniation
The entire spine is made up of vertebrae which sit on top of each other. In between each vertebrae is a disc which cushion the bones and enable movement. Sometimes these discs can 'herniate', also known as a prolapsed or slipped disc.
The name is slightly misleading as it sounds as though the whole disc has popped out of place. In fact this is not the case. What happens is that the inner part of the disc has bulged through the outer part.
The lower part of the spine is called the lumbar. Therefore a lumbar disc herniation is a slipped disc in the lower back.
Cauda equina syndrome
When a disc herniates, the inner nucleus which is bulging out can press upon the nearby nerves. The cauda equina nerves are situated in the lower back and can therefore be affected by a lumbar disc herniation. This is more common in large central disc herniations.
When a disc herniation compresses the cauda equina nerves, they will soon become damaged, after which they will not work as normal. This will lead to notable physical symptoms such as bladder dysfunction and numbness around the peri-anal region.
When neurological dysfunction arises due to a disc compressing the cauda equina nerves, the patient has cauda equina syndrome secondary to a lumbar disc herniation. It is estimated that this will happen in around 2% of lumbar disc herniations.
How should cauda equina syndrome be treated?
When cauda equina syndrome arises secondary to a lumbar disc herniation, the patient must undergo emergency decompression surgery. The operation will remove the fragment of disc that is irritating the nerves, ensuring they do not suffer any more harm.
What might amount to medical negligence?
The treatment for cauda equina syndrome is needed as an emergency. Unless the nerves are decompressed quickly, the patient will be left with permanent dysfunction. If the patient's condition is not diagnosed and treated when he/she presents to a medical setting (be it their GP, A&E or another medical service) and this causes a delay, there could be grounds for a negligence claim. Contact us to find out more.
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