Thursday, 30 April 2015

Bolt Burdon Kemp: When your spine can hold you back – Spinal Infections

Raquel Siganporia
Over the last few years there have been several successful and highly-valued claims where patients have sued their doctors for failing to diagnose infections of the spine or failing to act promptly.

The spine, like any other part of the body, can suffer from infection. Such an infection can be very serious and have hugely significant effects on the patient.

The infection may establish in the softer disc, or it may infect the harder vertebral bones. Once established in the back, the infection can spread up or down the spine in a cascade-effect.


How did I contract the spinal infection in the first place?
Most commonly, the infection arrives in the blood, having spread from other areas of the body.

The veins in the lower spine drain the pelvic area, bladder and prostate. As these areas are naturally susceptible to infection, it is quite common for infections of the spine to follow on.
Similarly, medical procedures can introduce infection to these areas which can then spread to the spine e.g. a cystoscopy that introduces bacteria to the bladder may result in an infection of the spine.


Risk factors

As infection of the spine tends to be a secondary infection, anything that reduces the immune system will increase the risk of this occurring. Risk factors include:
  • Malnutrition
  • Diabetes
  • Immunodeficiency
  • Recent infections


How do I know whether I have an infection of the spine?

The infection will often present as back pain. It normally sets in steadily over a long period of time.

As the infection progresses, there are some clear warning signs, sometimes referred to as ‘red flags’, to watch out for:
  • Fevers and/or chills
  • Headaches
  • Weight loss
  • Stiffness of the neck
  • Weakness, numbness or tingling in the arms and/or legs.
  • Worsening pain at night


What to be aware of

First and foremost, your doctors should take every precaution to ensure that they do not introduce an infection when carrying out any procedures. They must use sterile equipment and the appropriate aseptic technique.

Secondly, your doctors should be alert to an onset of back pain following any procedure to the pelvis, bladder or prostate.

Thirdly, if an infection has entered your spine, your doctors should be quick to diagnose and appropriately manage it so as to prevent any damage being caused.


How serious is an infection of the spine?

If an infection of the disc is left undiagnosed and/or untreated, the infection will gradually cause the tissue to decay and weaken. Left for long enough, the disc will eventually collapse.

Once a disc has collapsed, the space between the vertebral bones decreases. This pinches the nerves running down the spine and causes pain.

If the infection is in the vertebral bones (osteomyelitis) and is left untreated, the vertebrae will weaken and collapse, much like the disc does. However, as the vertebrae are bigger, decay leads to a more significant shortening of the spinal column and an increase in pressure. In addition, as the curvature of the spine shortens, the internal angles increase and this pinches the nerves further. Too much pressure on the nerves can interfere with the way they work and can cause bodily functions to go wrong.

Alternatively, the infection might spread from the vertebrae into the spinal canal, causing an abscess. Such a growth within the narrow canal will then place extreme pressure on the nerves and can result in paralysis.

An infection of the spine can, therefore, be very serious if left untreated.


How would the infection be treated?

It is most likely that medics will try to initially manage the infection conservatively (i.e. avoid surgery) with medication.

If the infection is too extensive, surgery may be required to remove much of the infected tissue. Surgery will also be necessary if there is evidence that the infection has destabilised the spine or is causing pressure on the spinal cord.


Does the spine recover after an infection?

Assuming the infection has been caught early enough and there is no irreparable damage to the nerves, the spine can largely recover naturally over time.

Collapsed discs can often be managed conservatively with appropriate therapy and management.

Equally, the vertebrae, like any bone in the body, can heal. However, while most bones heal by fusing the damaged area, a damaged vertebrae heals by fusing to other vertebrae .This will not only impact on flexibility and mobility, but can continue to put some pressure on the spinal cord, causing continuous pain.

However, if the infection has been allowed to progress and significant damage has been done, then it may be the case that surgery is required to ensure a good recovery.
If the infection has advanced too far, significantly damaging the nerves in the spine, recovery may not be possible and the paralysis can be permanent.

Over the past 25 years, Bolt Burdon Kemp has achieved strong results for both adults and children affected by spinal injuries. We can assist you in bringing a claim following a spinal injury whether your injury occurred as a direct result of an accident or as a result of substandard medical treatment.

For further information, or if you have any questions, feel free to contact Bolt Burdon Kemp’s Head of Spinal Injury, Raquel Siganporia on 020 7288 4844 or at

Raquel Siganporia
DDI +4420 7288 4844
Mobile: +447912 248985
Bolt Burdon Kemp
Providence House, Providence Place, Islington, London N1 0NT
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Wednesday, 29 April 2015

Tollers: Personal Injury Trusts

If you are making a claim for compensation as a result of an accident/incident, you need to be aware that any award of damages may impact on your entitlement to means tested benefits (now or in the future).  At present, if your household capital exceeds £16,000, you will not be entitled to means tested benefits, such as housing benefit or council tax support.  Therefore, receiving compensation may mean that you are no longer entitled to benefits that you need.

It is, however, possible to place your compensation monies into a specially drafted Trust which preserves your entitlement to means tested benefits.  The compensation monies will then belong to the Trust and need not be taken into account on any assessment of your entitlement to benefits (so long as the Trust is administered properly).

The Trustees are responsible for looking after the money and making payments out to you, the beneficiary, as and when required.  You can be a trustee of your Trust, along with another person, and therefore will retain a large degree of control over your compensation. 

It is extremely important to consider creating a Trust as soon as you can, even before your claim has settled.

If you would like further information on Personal Injury Trusts please contact Tollers' Trusts and Estates Team on 01604 258558.

Wednesday, 22 April 2015

Tollers: Lasting Powers of Attorney (LPA)

An LPA is a legal document by which a person authorises someone they trust to manage their affairs. It is an important document to consider as it enables a person to retain control over their affairs for as long as possible (either financial or health) and confirms how the power can be used by the Attorney if needed.

A Property and Finances LPA can be used to pay someone's bills whilst they are in respite/rehabilitation/hospital, to sell someone's house in the event that they are unable to deal with the paperwork, and deal with their other financial assets in their best interests.

A Health and Welfare LPA can only be used in the event that the person has lost capacity to make a specific decision in relation to their health and welfare, but can give the Attorney wide reaching powers in respect of healthcare.

These documents should be a consideration at any age, as assistance may be required following an illness or accident, which has impacted on a person's ability to manage their affairs.

Contact us for further advice on the nature and effect of an LPA.

Paul Morrison - Head of Personal Injury
Tollers Solicitors 01604 258558