Does Cauda Equina Syndrome Have To Be Treated in 24 Hours?
There is considerable debate regarding the timing of cauda equina syndrome. Some medical experts suggest the condition must be treated within 24 hours of the onset of symptoms if a patient is to make a good recovery. But others say that the timing of surgery is of no consequence and that the outcome will be the same.
Timing of surgery – the differing opinions
There have been various studies in recent history that support differing points of view.
A study that is commonly quoted is that made by Ahn et al. In their analysis of surgical outcomes, published in the year 2000, they say that for the best outcome the patient must undergo decompression surgery within 24 hours of their symptoms starting. Surgery performed within 48 hours of the onset of symptoms will lead to some improvement, but after 48 hours the nerves will be irreparably injured.
This opinion is opposed by some researchers. For example, a study by McCarthy et al, published in 2007, states that the duration of symptoms before the operation bears no influence on the outcome.
Cauda equina syndrome emergency treatment
However, the general consensus between most medical practitioners is that cauda equina syndrome must be treated as soon as possible. To give the patient the best chance of recovery, decompression surgery must be achieved while the condition is incomplete – where there is some bladder control.
Most patients with cauda equina syndrome will become gradually worse with time. This is because their nerves are becoming more and more damaged as the compression continues. Therefore to prevent any further injury being sustained, decompression surgery is needed on an emergency basis – which means within 24 hours of being admitted.
Nevertheless, this course of action may be slightly different if the patient already has complete cauda equina syndrome – where there is urinary incontinence. By this stage the nerves have become severely damaged already and immediate surgery may not be necessary, as it would not markedly improve the patient's outcome.
Even so, a patient with complete cauda equina syndrome does need decompression surgery. Medical experts generally agree that this can be done on an urgent, rather than an emergency, basis.
I think my treatment was delayed
Do you think your cauda equina surgery was delayed beyond 24 hours because of medical errors? If so, contact us at Glynns Solicitors – you could be the victim of medical negligence.
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