What happens if a spinal cord injury is left untreated?

If you have had an accident, and may have suffered a SCI, the following symptoms would be “red flags”:

• extreme back pain or pressure in the neck, head or back;
• weakness, incoordination, or loss of control in any part of the body;
• numbness, tingling or loss of feeling in the hands, fingers, feet, or toes;
• loss of bladder or bowel control;
• trouble with balance and walking;
• trouble breathing;
• a twisted neck or back.

It is not always immediately obvious that you have suffered a serious spinal cord injury. Numbness or paralysis can come on quickly or more gradually. It is important to assume the worst, and in the event of an accident where SCI is suspected, the injured person should not be moved.

If you sustain a traumatic injury to the spine, such as a fracture or crushing injury to a vertebra, additional damage is likely to occur over the following days and weeks, because of bleeding, swelling, and fluid accumulation in and around the spinal cord. It is important for doctors to be alert to the likelihood of this kind of deterioration.

Another type of spinal cord injury which can develop surreptitiously is a spinal abscess. This is caused by an infection inside the spine. Spinal abscess is more likely to develop if you have:

• back injury or trauma (even if minor);
• boils on the skin;
• had a recent lumbar puncture procedure;
• injected illicit drugs.

If the abscess grows and begins to compress the spinal cord it can lead to long term damage to the cord, and lead to paralysis. Abscesses grow relatively fast once they take hold, and severe deterioration can take place over a period of a few days.

Cauda equina syndrome (CES) is another condition which can deteriorate quite suddenly, leading to a severe outcome. The “red flags” for CES include:

• difficulty initiating urination/impaired sensation of urinary flow;
• loss of sensation of rectal fullness;
• saddle numbness;
• erectile dysfunction;
• bilateral sciatica;
• major motor weakness of the legs.

Failure to decompress the affected cauda equina nerves can lead to permanent disability, including loss of bowel and bladder function, and impaired sexual function.

The spinal cord can also be badly affected by spinal tumours. Fortunately, these are rare. There are different types of primary spinal cord tumours:

• meningiomas;
• tumours of the spinal nerves (neurofibromas and schwannomas);
• ependymomas.

Symptoms of spinal cord tumours include pain, numbness or weakness in different parts of the body. You may also lose control of your bladder or bowel.

Unfortunately, injury to the spinal cord can also occur during spinal surgery. For example, during scoliosis correction surgery it’s necessary to operate very close to the spinal cord, and hence there is a real risk of damaging the cord. The spinal cord is carefully monitored during such procedures via electrical testing. Despite this, damage to the cord does occur during surgery and may lead to paralysis in the worst scenario.

In all cases it is important to maintain a high index of suspicion of spinal cord injury. Following traumatic spinal injury patients should be admitted to hospital and kept under close observation. The MRI scan is the most important and effective investigation and is vital in diagnosing impending damage to the spinal cord, spinal abscess, cauda equina syndrome and spinal tumours.

Careful attention should be paid to “red flag” symptoms such as those listed above for CES, and referral for urgent MRI is required in the event of any such symptom being present.

In the event of injury to the spinal cord during surgery, it is very important to pick up early warning signs of likely cord injury, such as rapidly falling blood pressure, or loss of electrical signals. Surgery should be discontinued immediately if there is any possibility that spinal cord injury has occurred.

As specialists in spinal injury claims arising from clinical negligence, we have represented many clients who have sustained spinal cord injury as a result of some of the scenarios discussed above.

For example, we have successfully claimed damages for clients with sciatica who have not been given “red flag” warning advice in relation to CES, and as a consequence when such “red flag” symptoms arose (a change in sensation when urinating) did not act quickly enough and were left with permanent symptoms of incontinence and sexual dysfunction.

Similarly, we have recovered damages for clients who developed very clear symptoms of CES (saddle numbness, urinary dysfunction) but where that obvious diagnosis was missed at the emergency department, leading to an extensive delay in undergoing surgical decompression of the cauda equina nerves, and as a consequence, permanent issues of incontinence, sexual dysfunction, impaired mobility and loss of employment.

We have recovered millions of pounds of damages for a client who suffered a delay in diagnosis of spinal abscess, leading to the abscess growing and pressing on the spinal cord, causing irreversible paraplegia.

We have also recovered millions of pounds of damages for a teenage client who underwent surgery to correct scoliosis, but where monitoring of the functioning of the spinal cord intra-operatively was not carried out adequately, leading to paralysis.

We are highly experienced in dealing with cases where there is injury to the spinal cord, or to the cauda equina nerve roots, and in restoring lives by recovering life-changing sums of damages.