The BBC legal correspondent Clive Coleman today has highlighted what he terms “the little known spinal injury”, cauda equina syndrome, which is costing the NHS millions.

The story of Catrina Farnell, a talented dancer who has been left wheel chair bound with bladder and bowel damage along with sexual dysfunction due to what appears to have been a delay in seeking urgent medical treatment, is sadly all too common.

Most of us will suffer from low back pain at some point in our lives. Usually it is nothing sinister and will resolve in time often without any form of medical intervention or treatment.

In some cases, however, severe back pain can be a sign of cauda equina syndrome, which if left undiagnosed and untreated as in Catrina’s case, can result in severe injury and permanent damage to include paralysis of the legs, loss of bladder and bowel function, sexual function and other problems.

Cauda equina syndrome is a medical emergency and requires urgent surgical intervention. Patients with this condition suffer from a compression of the spinal nerve roots. They need fast medical treatment to prevent lasting damage.

Causes of cauda equina syndrome

CES can result from any number of events to include:

  • A ruptured disk in the lumbar area (the most common cause)
  • Narrowing of the spinal canal (stenosis)
  • A spinal lesion or malignant tumour
  • A spinal infection, inflammation, haemorrhage, or fracture
  • A violent injury to the back
  • Recent lumbar spine surgery

Symptoms of CES

CES can be extremely difficult for clinicians to diagnose because symptoms can vary and in some cases will come on slowly. The symptoms are also known to mimic other conditions such as a peripheral nerve disorder or spinal cord compression.

Red flag symptoms of CES of which patients should be aware include:

  • Severe low back pain
  • Motor weakness, sensory loss
  • Pain in one or more commonly both legs
  • Saddle anesthesia
  • Recent onset of bladder dysfunction (urinary retention or incontinence)
  • Recent onset of bowel incontinence
  • Sensory abnormalities of the bladder or rectum
  • Recent onset of sexual dysfunction
  • A loss of reflexes in the extremities

Treatment for cauda equina

Urgent diagnosis is paramount. Treatment is generally urgent surgery to relieve the pressure on the nerves. It is essential that surgery is undertaken promptly to prevent any permanent damage. It is considered best for surgery to be undertaken within 48 hours of the onset of symptoms. Sadly, even with prompt medical treatment a patient will not always recover full function.

There are quite simply too many occasions where lasting injury could have been avoided with prompt diagnosis and treatment. Not only is there a need for greater public awareness so that medical help is sought quickly by those affected but in addition there is a clear need for those involved in primary care and hospital doctors to be better informed and able to recognise the early signs and to ensure immediate investigation and treatment takes place.

Cauda equina compensation claims

Whilst a delay in diagnosis can lead to a substantial damages claim, no amount of damages will ever truly serve to compensate those who have suffered avoidable harm and life changing injuries.

Paula Barnes is a partner at Lester Aldridge who specialises in spinal injury compensation claims. Please contact her if you would like further information on this topic, or visit our Personal Injury & Medical Negligence page to find out how we can help with making a claim.