Neurosurgical Error Allegedly Causes Athlete To Develop Cauda Equina Syndrome

Case Overview

This case involves a 28-year-old female rock climber who developed cauda equina syndrome after undergoing a microdiscectomy. The patient suffered a large paracentral herniated disk while on an outdoor climb and had intractable pain down her leg at the time of surgery. She had no loss of bowels or saddle anesthesia prior to the surgery. The neurosurgeon performed the operation initially utilizing the METRx surgery system. The neurosurgeon then switched to an open procedure after discovering spinal fluid leaking from a tear made during the placement of the METRX surgical dilators and tube. The patient awoke in severe pain in her legs, numbness to her perineal area, and was left incontinent. Additionally, the neurosurgeon never told the patient that she had developed cauda equina syndrome. She later went for a second opinion and obtained the correct diagnosis there. An expert in neurosurgery was sought to review the medical records and opine on the standard of care.

Questions to the Neurosurgery expert and their responses

How often do you use the METRx system when performing microdiscectomies?

I am very familiar with the METRx system.

What are some common complications of the procedure described? Is Cauda equina syndrome one of them?

Some common complications include radiculitis, recurrent disk herniation, infection, epidural hematoma, CSF leak. Cauda equina syndrome is rare. If the symptoms were due to compression from excessive dural repair glue applied or from a postoperative hematoma that was not diagnosed, then this is a clear case.

About the expert

This highly-qualified expert in neurosurgery obtained his BS in microbiology from Cornell University and his MD from the University of Chicago. He completed both his internship in general surgery and his residency in neurosurgery at the Albert Einstein College of Medicine. He then went on to complete his fellowship in complex and minimally invasive spinal surgery at the University of Pittsburgh. He is a member of the prestigious International Society for the Advancement of Spine Surgery, the North American Spine Society and the American Association of Neurological Surgeons. Formerly, he has held roles as an attending neurosurgeon at UPMC Shadyside Hospital, Montefiore Hospital, Presbyterian Hospital, and as the chief of neurosurgery at Jersey City Medical Center. He is currently the chief of neurotrauma at a major hospital in New Jersey, an associate professor at a medical school in New Jersey, and an attending staff member at multiple hospitals in Northern New Jersey.