Was My Cauda Equina Syndrome Surgery Negligent?
If you still have distressing symptoms of pain and incontinence after surgery for cauda equina syndrome, you may be wondering if your surgery was in some way substandard.
Cauda Equina Syndrome
Cauda equina syndrome is a condition caused by the compression of the cauda equina nerves in the lumbar region of the back. It can produce symptoms of lower back pain, leg pain and/or numbness, and urinary, bowel and sexual dysfunction.
Surgical decompression for cauda equina syndrome
Ideally, surgical decompression for cauda equina syndrome will facilitate a degree of recovery of function but patients should be counselled that this may not happen and that a prevention of further deterioration would still be considered a successful outcome.
Having said that, it would appear that some CES patients go on to make a full recovery after surgery and approximately 75% are thought to have improved urinary function despite retaining some symptoms. However, it is a complex condition and the manner and extent of neurological damage and the degree of recovery will vary considerably. Therefore, some patients do not experience improvement of symptoms after surgery.
Medical Negligence
The key area of debate and frequent focus of medical negligence claims in relation to cauda equina syndrome is not so much the quality of the surgery itself but the timing of when that surgery was carried out.
Where a patient still retains some control and awareness of their urinary function at the time when they are diagnosed with cauda equina syndrome (described as CES-I), it is generally considered that surgery should be undertaken as an emergency. Studies have found that those patients have the best chance of recovery or improvement if surgery is carried out within 24 - 48 hours. It is imperative that the nerves are decompressed before the patient loses urinary function completely as there appears to be a poorer prognosis once this has occurred.
Therefore, if surgery is delayed, despite a diagnosis of CES-I, thereby allowing the patient's symptoms to deteriorate and leading to a poorer outcome, the hospital in question may have been guilty of substandard medical care.
If, however, the patient presents with symptoms of cauda equina syndrome with retention (CES-R), referring to complete loss of urinary sensation and function, the timing of surgery is thought to be less significant as the prognosis is already poorer. It would still seem preferable to have surgery promptly as a delay may lead to a worsening of symptoms but the relationship between timing of surgery and improved outcome is less clear.
In this scenario, a patient emerging from surgery with little or no improvement in symptoms may well have received a timely and good quality of care but have been unfortunate in the early development of their condition.
Speak to a solicitor
If your continuing symptoms have been caused by a delay in diagnosing or treating your condition, you may have been the victim of poor medical care.
Contact Glynns Solicitors to discuss your circumstances. We are a team of specialist medical negligence solicitors with considerable expertise in cauda equina syndrome cases and would be happy to support your claim for compensation.
Please call us on 0800 234 3300 (or from a mobile 01275 334030) or complete our Online Enquiry Form.
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