The BBC has recently reported on the ongoing failure to identify and treat a rare spinal condition known as Cauda equina syndrome (CES). CES is a condition which occurs when the nerves at the base of the spinal cord are squeezed together by the spinal vertebrae. The name relates to the lower end of the spinal cord, where the nerves all span out like a horse’s tail. ‘Cauda equina’ is the Latin term for ‘horse tail’.
Patients who have been diagnosed with CES have often had a long history of back pain and in the majority of cases, back pain can be simply dealt with by completing daily exercises recommended by your medical practitioner.
However, it is important that any red flag symptoms associated with the back pain are not overlooked, as they may indicate the presence of CES. It is the failure to recognise the red flag symptoms that can lead to a delay in diagnosing CES and this can be catastrophic for the patient.
The red flag symptoms include nerve pain down both legs, pins and needles or numbness in the bottom and inner thighs and a change in the bladder or bowel habit.
If a doctor suspects that a patient has CES, they must be admitted to hospital as an emergency. The longer it goes untreated, there is a greater chance it will lead to permanent paralysis and incontinence. The long term effects of CES include lower back/leg pain, problems with bowel or bladder control and decreased sexual function. In the BBC article John Reynard, a Consultant Urological Surgeon at Oxford University Hospitals NHS Trust said that, ‘Ideally you want to catch this condition in a matter of hours, do an MRI scan and do decompressive surgery’. However the shortage of NHS resources and lack of awareness in the medical field is causing more cases of CES to be missed.
There has been a steady number of clinical negligence cases involving the failure to diagnose CES, which highlights that this is an issue that needs to be addressed. It has been suggested that that doctors assess back pain cases alongside the red flag symptoms of CES, so that they can identify when a patient is at risk of the condition.
The 2019 NHS spinal services report has identified 22 recommendations for improving the patient experience, one of which is to provide 24 hour MRI scanning in all hospitals for patients with suspected CES. This will reduce the delay in receiving a crucial diagnosis and will allow the patient to have surgery earlier and hopefully avoid suffering any permanent problems.
Moosa-Duke Solicitors specialises in clinical negligence law and, particularly, in cases involving the failure to diagnose cauda equina syndrome. If you believe that you or a family member have received inadequate care from a GP or hospital Trust, please do not hesitate to contact us on 0116 254 7456 to discuss your concerns.