Cauda equina

Brain and nerves
1

Hi,

I have severe pain in my anus area, frequent diarrhea & Bowel incontinence for last 4-5 years . In 2013 I underwent a laser surgery for anal fistula .

Since then I have this problem .

Now since 2016 I have developed numbness in my legs and feet. My vitamin b12 level was too low , since I am a vegetarian . So I am also undergoing methy cobalamin injection therapy since January , as there is permanent damage to my nerves in legs.

Could it be cauda equina ? As anal pain around the outer area and

Bowel incontinence is due to this problem only .

My spine MRI doesn't show any problem though . How can we diagnose cauda equina ?

Munis

India

2

I am not medically qualified;  I am a legal professional, however:

'Red flag symptoms of cauda equina syndrome:

These symptoms are known collectively as the red flag symptoms of cauda equina syndrome and include:

Pain in both legs (bilateral sciatica)

Numbness in the genitals, perineum, buttocks and legs

Leg weakness

Urinary dysfunction

Bowel dysfunction

Giving advice about warning signs of cauda equina syndrome is not something that can be adequately explained in a minute or two. It requires explanation that nerve root compression affecting the leg can progress to affect the nerves affecting bladder, bowel and sexual function, as well as skin sensation in the genital/anal area. It then requires a description of the way in which each of these problems can present and advice to seek urgent consultation if they should occur.'

3

I think u don't have cauda equine

I had urgent surgury as l5 discs down had all come out and broke off crushing the nerves to my lower half. I have been left with drop foot right leg server weakness. I have a colostomy as my bowel stopped working and I had no wee flow so I at to have a ileal conduit. Wee bag . They left my bladder in but at to remove it after it went septic.

I have had 3 major ops dents 2 massive hernia and a colostomy revision. I was left for 6 days with cauda equine which if they had admitted me done a Mir scan the would have seen the problem. I was in pain for six days I sued and won. I had a bad back for about a year . Cauda equine means horses tail in Latin as the lower nerves look like that. I have established causa equine syndrome.. my life as been so hard my back is a mess pain they never supported the area in the back so the rest as got muti level changes. I have a compression of a nerve at the top . I a have a cervical spine. I am one of the worst outcomes for cauda equine in this country. Now u if u have no discs or other things growth and that. Which u say ur me I scan showed none of that plus my bowel and bladder were erratic before the operation. So that bowel problem does not fit that . I would see it doctor and discuss ur problem. I was unusual in the fact my bowl and bladder stopped working after the surgury. The nerves can recover mine did not . Hope this as help u in some way. Hope u get your self sorted. Keith

4

Hi Munis everyone experiences different symptoms. I had some similar to what you describe with regards to rectal pain and incontinence. Mine progressed to a full rectal prolapse as I lost all sphincter control. I was wearing diapers for about a year because the incontinence was so bad. It got to the point that my bowel would actually come out of me with a hard cough or if I tried to lift anything very heavy.

The reason I'm telling you about my bowel is because it is very rare for it to present like this before experiencing sciatica or severe back pain. Most people do end up with sciatica in one or both legs. I just had it in one leg and it wouldn't go away for months, a big indicator for a spine compression.

As the first reply said we are not doctors so we can only give our opinions but not medical advice. I don't think you can ever be too cautious though if you think you may have it and perhaps you should ask for a second opinion to review your mri, mistakes do happen and things get missed.

Misty

5

My undestanding as a legal professional specialising in medical negligence is that diagnosis is by MRI

 

6

The hospital doctors decide. I had erratic bowel and bladder when I was in full cauda equine. I did not get a me I scan for 5 days. Then they done one on tues at 17.15 they must of sent the scans to kings at Denmark hill I was woken in the early hours of weds rushed to kings from my hospital bed. I was on the operating table. At 6.0am I had complete compression of my nerves to my lower body... I had a lot of nerve damage I have a colostomy a ieal conduit wee stoma.

Now I have had lots of operations which I would never of had. I have had my bladder removed 2 hernia ops 1 stoma revision. Now my back as degentive changes all the way up I will had up with rods in my back the messed up their they never put any support in my back I have a curved spine. I will be asking if I have a case for that because if I had the support put in I would not have these big problems now. It's the same nhs trust. But ur answer if u are having problems with ur bladder and bowel and they can't find any reason the if u have sciatic pain and numbness they are signs I f I had been admitted straight away and a me I scan was done if the operated in the first 48 hours I would not have been as bad as I am I have foot drop and weakness on my right side.. I am the worst case of established causa equine syndrome in the UK. Hope this as helped. If u want a talk let me know and I will give u my mobile num. Keith

7

Dear Keith

To enable someone to assess a potential claim in negligence against the GP(s) for delaying in referral or by the Hospital Clinicians in, perhaps, failing to MRI and provide decompression surgery we would need to consider when you first experienced any of any of the following:

1.  Low back pain

2.  Pain in one leg (unilateral) or both legs (bilateral) that starts in the buttocks and travels down the back of the thighs and legs

3.  Numbness in the groin or area of contact if sitting on a saddle (perineal or saddle paresthesia)

4.  Lower extremity muscle weakness and loss of sensation

5.  Reduced or absent lower extremity reflexes

6.  Bowel and bladder disturbance:

Bladder disturbance related to cauda equina syndrome include the following:

(i)                  Inability to urinate (urinary retention)

(ii)                 Difficulty initiating urination (urinary hesitancy)

(iii)                Decreased sensation when urinating (decreased urethral sensation)

(iv)                Inability to stop or control urination (incontinence)

Bowel disturbance may include the following:

(i)                  Inability to stop or feel a bowel movement (incontinence)

(ii)                 Constipation

(iii)                Loss of anal tone and sensation

When did you complain of any of the above?

What action was taken and when?

On what date did you have an MRI

On what date did you undergo decompression surgery?

 A short chronology would be very helpful.

Kind regards

8

My claim took 5 years i sued a urology doctor and a nhs trust the nhs trust admitted liability. They failed from the start from evening sent to hospital with a gp letter. I waited 5 hours I could not feel my left leg was not seeing I could not feel my penis my back was agony .I see this young junior doctor who thought I was trying to sue jump for a operation he said he was not the middle man said goodbye. I wrote a note to my gp in the Monday he hit the roof. Sent me back up their by this time I was not well my leg was dragging the pain in my lower back was intense.

This time I was seen I was more force full. The doctor examined me then admitted me she was the same doctor that on the Friday evening sat at a desk at 19.30 doing nothing until she moved at 21.00 I asked her why she could not have see me and she said she wanted to be clear as she was going out. The next mistake I wad left in bed till the took me for a Mir scan on the Tues at 17.15. I was taken back at 01 something I had 2 ambulance men moving me I was blue lighted to kings at Denmark hill London. I was operated on I had a complete compression of my lower nerve root. I had every expert u could name they with me and a barrister all the facts were presented and they decide I had a case. As I say near 5 years the out the blue I was offered a settlement àfter 2 rejections I excepted it was a massive amount which I won't say unless I speak to u. They had a Mir scan done in the June that showed 3 disc were right out. 2 were joined together. I had years of pain. I go in st Thomas's London for 2 week assessments for neruomodulation surgury also my back is in a bad way I been told it's got multi level degentive changes. It's a curved and I am riddle with arthritis. The trust that done the emergency operation to decompress the spine did not put any support in my back . My back tramura team are saying no support as caused a lot of these on going problems. I today have gone to my solicitors and explained what as been said. They plan to see what can be done now I would like to know why. I have got good at reading these scans I have now had over 15 . The to hospitals concerned are now the same trust. My after care as been nil. As I said 2 aromas bladder removed hernia s stoma revision all this because I was left . The admitted full responsibility. I work for that trust for 11years before moving on to the mod.

I spent 6 weeks on my back because of a fall downstairs on to my back they done a scan and like for me I had the fall I had a massive infection around the operation site. I had been in hospital a few months before as I had a infection which got to my lungs weeks and weeks in the kings hospital. It's been a nightmare I have fought all the way to keep up right I have foot drop my leg go's died with out warning I use my stick to stop my falls I have had a few in doors my youngest daughter her husband and 2 girls live with us as my wife is disabled as well I live down stairs. It's pain every day as the said we done the compression but can't stop the pain.