What is Cauda Equina Syndrome?

Cauda equina syndrome (CES) has a funny name ("cauda equina" means "horse's tail") and serious implications, especially if not diagnosed and treated promptly. Cauda equina syndrome is a nerve root problem, in which there is pressure on the nerves at the very bottom of the spinal cord. This collection of nerves, which reportedly resembles the tail of a horse, gives the syndrome its name.

What Are the Symptoms and Causes of Cauda Equina Syndrome?

The symptoms of CES vary and may come on slowly, making them difficult to identify right away.

Some of these symptoms are also found in a variety of other conditions. Symptoms include:

• Severe pain in the lower back
• "Saddle anesthesia," or numbness in the parts of your body that would sit in a saddle if you were riding a horse
• Loss of sensation, or altered sensation in your legs, inner thighs, or feet, especially if it becomes increasingly worse
• Weakness, numbness, or pain in one or both legs
• Sudden onset sexual dysfunction
• Recent onset difficulties with bowel or bladder function, including incontinence or difficulty passing urine or stool.

You should consult a doctor immediately if you experience any of these symptoms, especially in combination..

Cauda equina syndrome is most frequently caused by a ruptured disk in the lumbar area. Other causes include stenosis (narrowing) of the spinal canal, spinal infection or fracture, spinal lesion or tumor, and a severe injury to the lumbar spine. Unsurprisingly, it's more common in adults than children, although it does occur in patients of all ages. Fortunately, CES is generally rare overall. But because it's so serious, doctors should take measures to rule it out if a patient is having any of the symptoms above.

What Happens if Cauda Equina Syndrome is Not Treated in Time?

If you're having symptoms of CES, "wait and see" is the wrong approach to take. The longer it takes to get diagnosed, the greater your chances of long-term or permanent problems involving sexual problems, bowel and bladder issues, and permanent nerve damage resulting in weakness and numbness.

With symptoms of CES, you should go to a hospital for diagnosis and treatment as quickly as possible. Your regular primary care doctor may not have the experience or the tools to correctly diagnose CES, and failure to diagnose will have serious consequences..

The diagnostic process includes taking a medical history and a physical examination to evaluate your reflexes, sensation, strength, and stability. Blood tests may also be required to look for infection or other causes of your symptoms. It's likely that you will need to undergo an MRI or CT scan so the diagnosing doctor can view images of your spine. You may also be given a myelogram. This is an X-ray of your spinal canal after an injection of contrast dye.

If you are diagnosed with CES, surgery must be performed as quickly as possible to relieve pressure on nerves and prevent permanent damage leading to paralysis or other long-lasting outcomes, including loss of bladder, bowel, and sexual function. Ideally, surgery should take place within 48 hours of the onset of your symptoms, so you can see that waiting three days for a doctor appointment, then a referral to a specialist for tests, is not acceptable. Depending on the cause of your CES, additional treatment may be needed after surgery.

What if My Doctor Failed to Diagnose Cauda Equina Syndrome?

Cauda equine syndrome is rare, but that doesn't mean a doctor shouldn't consider it, especially if your symptoms and medical history point in that direction. If your doctor failed to take a thorough history or perform tests that would allow for a correct diagnosis, he or she may have committed medical malpractice.

Because the symptoms and complications of CES have such a profound effect on quality of life, you should strongly consider pursuing a medical malpractice action for a delayed or missed diagnosis. Contact an experienced Portland medical malpractice attorney with experience in cauda equina syndrome cases to discuss whether you have a case and how it should proceed.