“We identified that decompressive surgery within 24 hours of onset of autonomic symptoms in cauda equina syndrome incomplete reduces bladder dysfunction at initial follow-up”… SPINE. Volume 40, Number 8, pg. 580-583.

What else did the article, “Does Early Surgical Decompression in Cauda Equina Syndrome Improve Bladder Function” report?

“For the 36 CESI less than 24 hours, normal bladder function was seen at follow-up in all patients except 4. However, for 103 patients with CESI more than 24 hours, 48 had bladder dysfunction. In fact, even operating within 48 or 72 hours for patients with CESI made a statistically significant difference.”

The most common causes of acute cauda equina syndrome are massive herniated discs, epidural hematomas, or spinal infections that cause compression of the spinal nerves in the lumbar spine that result in bowel and bladder dysfunction, lower extremity motor and sensory loss, and sexual dysfunction.

Regardless of the cause, cauda equina syndrome is a neurosurgical emergency that must be timely identified and fast-tracked to the operating room. Any failure to diagnose this condition that results in an unnecessary delay in getting the patient to the operating room is negligent conduct that supports a malpractice claim. The question invariably becomes: Did the failure to timely surgically decompress the nerves make a difference in the outcome?

North Carolina Supreme Court has ruled that a plaintiff must show that the loss of chance of a better outcome was greater than or equal to 50% to prevail and has rejected the loss of chance doctrine that allows recovery of money damages for lessor percentages. For example, under the loss of chance doctrine, if the jury finds that the negligent conduct resulted in only a 40% chance of a better outcome, the plaintiff would recover 40% of the money damages.

Greg Vigna, MD, JD, practicing spinal cord injury physician, national neurological injury attorney, and Certified Life Care Planner states, “We represent a young man in Wake County, North Carolina who has suffered a permanent injury caused by a failure to diagnose and treat a massive herniated disc that caused cauda equina syndrome. It is important to understand the state’s law and the medical literature as it relates to surgical outcomes before bringing cases against negligent medical providers who fail to identify the red flag warning symptoms of cauda equina syndrome and act accordingly for this neurosurgical emergency.” (In the General Court of Justice Superior Court Division 22-CV-015018).

RED FLAG WARNING SYMPTOMS of Cauda Equina Syndrome include:
1) Severe back pain
2) Genital numbness
3) Urinary retention, difficulty voiding, incontinence of urine
4) Constipation, inability to evacuate bowels
5) Bilateral leg pain, weakness, numbness

Dr. Vigna is a California and Washington DC lawyer who focuses on catastrophic neurological injuries. He is a retired physician, a Certified Life Care Planner, and an expert on spinal cord injury, cerebral palsy, and cauda equina syndrome. He represents serious neurological injuries across the country with Ben Martin Law Group, a Dallas Texas firm. Ben Martin is a national pharmaceutical injury trial attorney and personal injury lawyer in Dallas, Texas.

To learn more from Dr. Vigna: https://vignalawgroup.com/practice-areas/sci-spinal-cord-injury/