Cauda Equina Syndrome (‘CES’) is the name given to a relatively rare neurological condition which is a type of spinal cord injury.
The cauda equina, meaning ‘horses tail’ in Latin, is the name given to the bunch of nerve roots found at the bottom of the spinal cord, and CES arises where these nerves are damaged. Where CES is suspected, this should always be treated as a surgical emergency. From the onset of the condition there is a very small window of opportunity to diagnose and operate before permanent damage is done to the spinal cord. Depending on the cause of the compression, emergency surgery will be required within approximately 12 to 48 hours of the initial onset of symptoms to provide the best possible outcome for the patient. In the worst cases where surgery is not performed in time, sufferers are left with permanent paralysis from the waist down, to include a complete loss of motor and sensory function in the legs, bladder and bowel.
Signs and Symptoms – Red Flags
There are 5 NHS red flags:
- Loss of sensation in the perineum/ between the legs
- Disturbed bladder/ bowel function – either incontinence or retention
- Severe back pain
- Leg pain affecting one or both legs
- Motor weakness and loss of reflex(es)
Any GP who suspects CES will advise their patient to proceed immediately to A&E for an emergency MRI scan. The scan will usually show whether or not immediate surgery is required.
CES Claims and the Law
Most CES claims arise from patients who have not been properly examined by their GP or in hospital leading to a significant delay before surgical intervention. The UK has a particularly poor record for CES, because of a general lack of awareness about the condition, and poor reaction times for the diagnostic MRI scan and transfer to theatre for immediate surgery.
All medical professionals owe a duty of care to their patients, but they will not be guilty of negligence if they act in accordance with a practice accepted as proper by a respectable body of medical practitioners skilled in their particular area of medicine. For a doctor or an NHS Trust to be found negligent it must be shown that the patient was provided with inadequate treatment. Generally this can be proved in one of four ways:
- Absence of urinary investigation
- Failure to carry out a neurological examination
- Failure to order or a delay in ordering an MRI scan
- Significant delay
How we can help?
Claims for compensation arising from CES are complicated to win, and an inexperienced solicitor will recover only a fraction of the true award owed to a successful claimant. Only experienced catastrophic injury solicitors, approved by the Spinal Injuries Association, should act for CES sufferers.
Please contact Ben Posford for free advice about whether and how you can bring a claim for compensation for the injuries and other losses suffered as a result of CES.
Contact Ben Posford on firstname.lastname@example.org, 020 7485 8811 or 07539 926767
Read Ben’s article which appeared in the Septembers 2013 Personal Injury Brief Update Law Journal, discussing the implications of a decision made by the High Court in his Cauda Equina Syndrome case Cooper v Bright Horizons Family Solutions Ltd  EWHC 2349.