New interactive advice for diagnosing and treating Cauda Equina Syndrome | Fieldfisher
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New interactive advice for diagnosing and treating Cauda Equina Syndrome

The little known condition Cauda Equina Syndrome affects 1-3 people per 100,000 of the population in England, with approximately 8,000 suspected cases every year.

The Clinical Negligence team at Fieldfisher is keen to raise awareness of this challenging condition since delayed diagnosis and late access to treatment can have a devastating impact on a person's quality of life.

What is Cauda Equina Syndrome?

Cauda Equina Syndrome is the compression of a collection of nerve roots – the Cauda Equina - most often caused by a prolapsed disc. In instances of acute Cauda Equina Syndrome, the onset of symptoms is sudden and severe, and surgery is required within 24-48 hours.

Symptoms include:

  • Numbness and weakness in one or both legs
  • Deterioration or loss of bowel and/or bladder control
  • Numbness of the saddle area around the back passage


Urgent spinal decompression surgery is the most common treatment, but a failure to treat the condition within the first 48 hours can lead to permanent nerve damage including:

  • Permanent paralysis
  • Loss of bladder and/or bowel control
  • Loss of sexual function 

GIRFT's first interactive pathway

In February this year, the Getting it Right First Time Team (GIRFT) at NHS England published a new clinical pathway to help clinicians diagnose and care for patients with suspected Cauda Equina Syndrome. 

Timely diagnosis is essential because the longer patients go without the right treatment, the greater the risks of permanent paralysis and incontinence.

Last week, GIRFT launched its first interactive pathway, outlining best practice for clinicians caring for patients with suspected Cauda Equina Syndrome. 

The interactive pathway has been developed as a web-based tool designed for use by clinicians, nurses and allied health professionals at every stage of the patient pathway, from GP presentation to post-operative care. 

It guides practitioners through examples of the processes and key decisions they should work through for diagnosis, treatment and follow-up of patients in their care and is a welcomed advancement to early detection and safeguarding of patients.

The Fieldfisher team has dealt with cases where the early signs and symptoms detailed above have been missed, resulting in irreversible damage and disability, affecting almost every aspect of a patient's quality of life. 

If you have suffered from Cauda Equina Syndrome and a delay in effective treatment, please contact the team for initial advice.

Further information and help is available from charities supporting people living with the devastating impact of the condition: The Spinal Injuries Association (SIA) and the Champions Charity

Read more about Fieldfisher's spinal injury cases:

£4.1m for man left wheelchair bound because of mistakes diagnosing spinal abscess | Fieldfisher