Cauda Equina Syndrome & Malpractice Compensation Amounts
The human back contains three types of vertebrae--cervical, thoracic and lumbar--that provide structural support to the skeleton and protect the spinal cord. Extending from the brain, the spinal cord sends signals to the body's muscles and other structures through nerves. The spinal cord ends near the first lumbar vertebrae and forms the conus medullaris. Directly beneath the conus medullaris lays a bundle of nerves known as the cauda equina. When these nerves face extreme compression or trauma, a condition known as Cauda Equina Syndrome (CES) occurs.
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Symptoms
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Cauda Equina Syndrome may present a variety of symptoms. These include lower back pain or radiating leg pain, often known as sciatica. In some cases, perineal paresthesia, a condition characterized by numbness in the groin, may occur. There may also be urinary and bowel manifestations, such as difficulty or inability to urinate, constipation, decreased sensation while urinating or incontinence.
Causes
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Just as CES has many symptoms, it also has many causes. It is most often caused by an underlying condition. These include herniated disks, tumors and neoplasms. Trauma to the area from spinal fracture, gunshots, stab wounds, or spinal dislocation may cause CES. Other conditions, such as those of an inflammatory or infectious nature, may also lead to Cauda Equina Syndrome.
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Iatrogenic Causes
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It is also possible for CES to result from accidental medical causes. These often occur during a medical procedure and are often preventable. Poorly positioned screws in the spine, continuous spinal anesthesia, and lumbar puncture (known as a spinal tap) in anticoagulation therapy patients may all lead to nerve damage and compression.
Treatment
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Depending on the underlying cause of CES, different treatment options are available to patients. Symptoms of ankylosing spondylitis and similar inflammatory conditions lessen with use of ibuprofen and corticosteroids, while antibiotics help to fight off infections. In cases of neoplasms or spinal tumors, CES requires chemotherapy or radiation therapy to ward off further complications. When a patient presents with either leg pain or numbness, a doctor will perform emergency surgical decompression. Herniated disks may require one of two surgical procedures. A laminectomy removes surrounding bone tissue, while a discectomy removes the compressed nerves.
Malpractice Suits
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The outlook for patients suffering from Cauda Equina Syndrome become worse the longer they go untreated. Because of this, many malpractice suits have been filed against health practitioners. Lawyers at Biren|Katzman reached an award amount of $1,575,000 for a construction worker left paralyzed after undiagnosed CES. In a similar case, a client of Leon Assprung, M.D., received $1,200,000 after receiving delayed treatment of CES.
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- Photo Credit Image by Flickr.com, courtesy of Andrew Barden
