Rare spinal conditions and why these can result in medical negligence claims

Rare spinal conditions can have devastating, life‑altering consequences if they are not identified and treated quickly.

In some cases, these delays happen because healthcare professionals fail to recognise critical ‘red flag’ symptoms or act with sufficient urgency. This can cause permanent neurological damage, significantly affecting a person’s quality of life. When this happens, it may be considered medical negligence.

Below are examples of some of the rare spinal conditions the medical negligence team at Penningtons Manches Cooper sees, what can go wrong, and the impact this can have.

Cauda equina syndrome (CES)

Cauda equina syndrome is a rare but serious medical emergency caused by compression of the nerve roots at the base of the spine. Red flag symptoms include reduced sensation in the saddle areas (the buttocks, perineum, gentiles and inner thighs), sexual dysfunction, bowel or bladder dysfunction and back/leg pain.

Common negligence issues include:

  • failure to recognise red flag symptoms;
  • delayed referral for an emergency MRI scan;
  • delay in performing urgent decompression surgery.

If not treated promptly, CES can lead to irreversible nerve damage, resulting in:

  • permanent incontinence;
  • sexual dysfunction;
  • lower limb paralysis.

Because of the red flag symptoms and the need for immediate intervention, cauda equina syndrome is one of the most frequently litigated spinal injuries.

Spinal epidural abscess (SEA)

A spinal epidural abscess is a rare but severe infection that develops in the space around the spinal cord, often leading to rapid neurological deterioration.

Common negligent issues include:

  • misdiagnosing symptoms as less serious conditions (eg musculoskeletal back pain);
  • failure to recognise infection indicators;
  • delayed MRI imaging;
  • delayed or inadequate antibiotic or surgical treatment.

Delayed treatment can result in:

  • permanent spinal cord injury;
  • paraplegia or quadriplegia.

These cases are particularly complex, as early symptoms can be subtle, but the consequences of delay are often catastrophic.

Syringomyelia

Syringomyelia involves the formation of a fluid‑filled cyst (syrinx) within the spinal cord, which can expand over time and compress surrounding nerves. Symptoms include chronic pain, muscle weakness and stiffness in the back, shoulders, arms or legs. The loss of sensation is often described as ‘shawl like’ as it affects the neck, shoulders and arms.

Common negligent issues include:

  • failure to investigate persistent neurological symptoms;
  • missed diagnosis of underlying causes (such as trauma or Chiari malformations);
  • lack of appropriate monitoring or treatment.

Delayed treatment can allow the cyst to progress and permanently damage the spinal cord causing:

  • chronic pain;
  • numbness and sensory loss;
  • loss of bowel or bladder control;
  • progressive weakness in the arms and legs.

Transverse myelitis

A rare inflammatory condition affecting the spinal cord, often presenting with rapid onset neurological symptoms including weakness in the arms and legs, numbness or tingling, sharp lower back pain, bowel and bladder dysfunction, and a tight feeling around the torso.

Common negligent issues include:

  • failure to recognise acute neurological deterioration;
  • delayed imaging and specialist referral;
  • delay in initiating anti-inflammatory or immunosuppressive treatment.

Early intervention is critical to limit permanent damage to the insulating myelin sheath and so delays can result in:

  • severe motor weakness or paralysis;
  • sensory impairment;
  • loss of bowel and bladder control.

Spinal cord stroke

This occurs when the blood supply to the spinal cord is disrupted, leading to sudden and severe neurological symptoms such as acute back/neck pain, rapid limb weakness, loss of sensation/numbness or tingling and muscle spasms. These strokes are often caused by vascular issues like blood clots or atherosclerosis.

Common negligence issues include:

  • failure to recognise symptoms due to lack of familiarity;
  • misdiagnosis as less serious conditions;
  • delay in identifying underlying vascular causes.

Due to its rarity, this condition is particularly vulnerable to misdiagnosis which can result in:

  • paralysis;
  • loss of sensation;
  • long-term disability.

Scoliosis surgical complications

While scoliosis surgery is relatively common, complex or severe cases can carry increased risks, particularly where surgical errors occur.

Common negligent issues include:

  • poor surgical technique;
  • damage to the spinal cord or nerve roots;
  • operating at the wrong spinal level;
  • inadequate stabilisation of the spine.

This can cause:

  • permanent nerve damage;
  • chronic pain;
  • loss of mobility or paralysis.

Emily Hartland, an associate in Penningtons Manches Cooper’s medical negligence team, comments: “In my experience, the common thread in most of these cases is delay – whether in recognising symptoms, arranging investigations, or initiating treatment. Although these conditions are uncommon, the impact of getting it wrong is significant and early action can make the difference between recovery and lifelong disability.”

If you have been affected by any of these issues and would like some professional advice, please call us on 0800 328 9545, e-mail clinnegspecialist@penningtonslaw.com or complete our online assessment form.

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