What is cauda equina syndrome?
CES can have devastating consequences, however, it is a relatively rare condition that mainly affects adults - although it can occur at any age.
14 May 2021
The cauda equina, which is Latin for horse tail, refers to the bundle of key nerves located at the lower end of the spinal cord. Compression, trauma or other damage to this area of the spinal canal can result in cauda equina syndrome (CES).
It's estimated that approximately 1-3 people in every 100,000 in the UK are affected by CES, which in many cases is as a result of a slipped disc.
All medical professionals are trained to look out for tell-tale symptoms of CES but there are a number of so-called ‘Red Flag’ symptoms which indicate the need to see your doctor as soon as possible so they can carry out further tests. Red flag symptoms should not be ignored or dismissed. These symptoms include:
- Severe lower back pain
- Pain/loss of feeling or muscle weakness in one or both legs or feet affecting your ability to walk
- A loss of feeling around the saddle area of your back
- Impaired bladder, bowel and sexual function
CES is a serious medical emergency that requires immediate referral for investigation and possible urgent surgical intervention. Receiving an early diagnosis and early surgical spinal decompression are vital for a positive outcome in most patients with CES. Without prompt treatment, adverse consequences can include permanent neurological damage.
If you think you have one or more red flag symptoms that suggest CES, your GP should ensure you're admitted to hospital immediately. Unfortunately, because CES is relatively rare, doctors can fail to detect the condition, especially when not all of the major symptoms are apparent.
Delays in performing surgery can result in permanent severe pain or loss of feeling in the legs and feet, permanent mobility problems, and irreversible bladder/bowel or sexual dysfunction.
Treatment for CES typically requires emergency surgical decompression to reduce or eliminate pressure on the nerve – ideally performed within the first 12-48 hours following the onset of symptoms to provide the maximum potential for improvement of motor and sensory dysfunction.
The most common type of surgery for CES is a ‘Laminectomy,’ which involves removing part of your backbone to release pressure on the nerves being compressed. The longer the delay in surgery, the more likely sufferers will be left with serious long term problems.
The prognosis for CES depends on a number of factors which includes the severity of the nerve damage and how quickly the affected nerve is compressed. Following surgery, the extent of someone’s recovery varies depending on the duration and severity of symptoms, and many patients may continue to suffer pain and/or continuing bladder, bowel and/or sexual dysfunction.
A failure to diagnose CES early enough, or a failure to carry out further investigation or surgery when CES is suspected, could be the basis for a potential compensation claim if neurological damage then occurs as a result.