19 Harley St, London, W1G 9QJ, UK

Causes and outcomes of cauda equina syndrome in medico-legal practice: a single neurosurgical experience of 40 consecutive cases

BACKGROUND: This is a unique report of 40 patients litigating in relation to the management of a cauda equina syndrome (CES), with prospective data collection. METHODS: Patients were seen and examined; medical records and radiological imaging were reviewed. The following data were collected prospectively: age; sex; the level of cauda equina (CE) compression; the pathology causing the compression; the clinical picture at first presentation; the causes of any iatrogenic injury; possible breaches of duty of care and the responsible discipline; recovery of bladder control; return to work. FINDINGS: There were possible breaches of duty of care for 39 patients initially, and for 69 patients overall. Twenty-eight patients presented with compressive degenerative pathologies (mainly central disc prolapses); all 28 had deteriorated to the point of bladder paralysis (complete CES (CESR)) at the time of treatment. Twenty-six (93%) had voluntary bladder control at presentation. Long-term bladder paralysis was probably avoidable in over 90% of patients. Eleven patients had iatrogenic injuries: all had long-term bladder paralysis. Thirty-four patients had bladder paralysis (CESR) at the point of decompressive surgery. Recovery of bladder function occurred in only seven patients (21%), i.e. long-term bladder outcomes were poor. Only 22% of patients returned to work. CONCLUSION: In this highly selected group of patients whose CES was not managed in an appropriate/standard fashion, 93% of patients had long-term bladder, bowel and sexual dysfunction that was probably avoidable. Mismanagement of patients with iatrogenic injuries was associated with a universally poor outcome

Keywords : Adult,Aged,Cauda Equina,Data Collection,Decompression,Surgical,Delivery of Health Care,Employment,etiology,Female,Humans,injuries,Intervertebral Disc Displacement,Intraoperative Complications,legislation & jurisprudence,Male,Malpractice,Medical Errors,Medical Records,methods,Middle Aged,Neurosurgical Procedures,Paralysis,pathology,Patients,Polyradiculopathy,Prolapse,Prospective Studies,Recovery of Function,Spinal Stenosis,standards,surgery,Syndrome,Time,Treatment Outcome,Urinary Bladder Diseases,Victoria,Young Adult,, Outcomes,Cauda,Equina, harley street spine clinic

Date of Publication : 2011 Aug

Authors : Todd NV;

Organisation : Regional Neurosciences Centre, Royal Victoria Infirmary, Queen Victoria Road, Newcastle upon Tyne, UK

Journal of Publication : Br J Neurosurg

Pubmed Link : https://www.ncbi.nlm.nih.gov/pubmed/21513452

The London Spine Unit : Harley Street UK. Specialists in Cutting Edge Technologies for Spinal Surgery

Make an Appointment 

Trustpilot Reviews
Doctify Reviews
Top Doctor Reviews

Causes and outcomes of cauda equina syndrome in medico-legal practice a single neurosurgical experience of 40 consecutive cases | €‹aans | artificial cervical disc surgery

What our patients say ...

Consultant Spine Surgeon
Consultant Spine Surgeon
Consultant Spine Surgeon

This surgical technique consists of a percutaneous approach for the treatment of small to medium size hernias of the intervertebral disc by laser energy. The main objective is to reduce the intradiscal pressure in the nucleus pulposus

Laser Disc Surgery can be performed under local anaesthetic as a day case at our centre on the prestigious Harley Street.
What is London spine unit and How it Works

The London Spine Unit was established in 2005 and has successfully treated over 5000 patients. All conditions are treated.

treatment of all spinal disorders

The London Spine Unit specialises in Minimally Invasive Treatments allowing rapid recovery and return to normal function

Trusted by patients worldwide

The London Spine Unit provides the highest quality care to all patients and has VIP services for those seeking exceptional services

If you have any emergency Doctor’s need, simply call our 24 hour emergency

Your personal case manager will ensure that you receive the best possible care.

Call Now 

+44 844 589 2020
+44 203 973 8810