Cauda Equina Solicitors

Cauda equina claims have a high medico-legal profile due primarily to the substantial levels of compensation that claims of this nature attract. Cauda equina syndrome compensation levels reflect the damaging and distressing nature of the condition.

Cauda equine syndrome (‘CES’) is the term used to describe compression of the nerves at the end of the spinal cord. The terminology, “cauda equina”, literally means “tail of horse” and refers to the bundle of nerves that divide at the end of the spinal cord. Compression of the spinal cord at this level can lead to serious and permanent neurological injury, hence the substantial levels of compensation referred to above.

In medico-legal terms the important distinction is whether, at any given time, the CES is complete or incomplete.

When the syndrome is incomplete (‘CES-i’), the patient has urinary difficulties caused by compression of the nerves. These difficulties can include altered urinary sensation, loss of desire to void, poor stream and the need to strain. Saddle and genital sensory deficit is often partial. The complete syndrome (‘CES-r’) is characterised by painless urinary retention and overflow incontinence. There is usually extensive or complete saddle and genital sensory deficit.

The reason why this distinction is key is that the outcome for patients with CES-i at the time of surgery is generally favourable. Unfortunately, those who have deteriorated to CES-r by the time the compression is relieved have a poorer prognosis.

In around half of cases the die is cast within the first 4-6 hours of a severe central disc prolapse resulting in CES-r. This is a very small window of opportunity in which to achieve referral to an appropriate hospital, confirm the diagnosis by MRI scan and then surgically decompress the nerves. In many cases the Defendant can argue that any delay on their part would not have changed the outcome in any event. The situation with regards to CES-i is, however, very different. Here the window of opportunity can extend over a much longer period, days or weeks. Prompt treatment offers a good prognosis.

The important issue is to avoid CES-r.

Punctual diagnosis and investigation, followed by a full explanation and consent procedure before timely and skilful surgery and rehabilitation, are the essentials of best practice. It is a tragedy, often avoidable, if an incomplete syndrome becomes complete when under medical supervision as CES-r often results in constant pain, bowel, bladder and sexual and lower limb dysfunction.

Compensation levels very. The industry accepted norm seems to be somewhere between £600,000 and £800,000 per claim.

Compensation levels can only ever be properly determined by reference to the extent of injury and personal circumstances. That said a further factor might also be the experience and quality of the legal advice given.

At Davies and Partners we have a team of experienced cauda equine syndrome solicitors specialising in cauda equina claims and our team has settled cases for more than £2.9 million – significantly above the national average. For anyone affected by CES the message is clear, top quality legal advice can make all the difference. Please contact our team of caudia equine solicitors to discuss your case.

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