Cauda Equina Syndrome (CES) results from a disc (the disc that separates your vertebrae) protruding or bulging and putting pressure on the central nervous system. All the nerves sending information to the lower half of your body (legs, reproductive organs, bladder and bowel) come out at the base of your spine. It looks like a horse’s tail (hence the name Cauda Equina which is latin for horse’s tail).
CES presents in 2 ways. It is either acute and comes on quickly (a day or 2) or it is chronic and comes on more slowly. However it comes on it is an emergency and should result in a referral to a spinal surgeon. There is only one way to treat the condition and that is to decompress the nerve root.
There are certain “red flag” signs of cauda equine. These include:
- Recent onset bilateral sciatic pain – (pain that radiates from the back down the leg)
- Numbness in the buttocks and in the saddle area (the bit between your anus and genitals)
- Numbness in both limbs
- Inability to pass urine or open your bowels
These signs should result in immediate referral to an orthopaedic surgeon who will arrange an MRI scan or send you to a hospital that has an MRI scanner. You will then need emergency spinal surgery to decompress the nerve root.
There is much scientific debate about the window within which surgery makes a difference but as a general rule those who have surgery within 24 hours of onset of symptoms do well and the longer the delay the worse the outcome.
GPs and Accident & Emergency departments should spot these signs and make immediate referrals. If the problems start whilst you are already in hospital failure to ensure prompt surgery is inexcusable.
Injuries caused by delays in diagnosis and referral of CES include:
- Loss of bladder and bowel function
- Loss of sexual function
- Mobility difficulties (foot drop or pain on walking)
- Paraesthesia (discomfort due to numbness )
The impact on the lives of those affected by these injuries can be vast. We can help get the funds needed to replace earnings, pay for carers, modify houses and pay for rehabilitation.