High-Riding Conus Medullaris Syndrome: A Case Report and Literature Review—Its Comparison with Cauda Equina Syndrome

This case report discusses Conus Medullaris Syndrome (CMS), a spinal cord injury affecting the conus medullaris. The conus medullaris is the tapered end of the spinal cord, and when it is compressed, it can cause a mix of upper and lower motor neuron signs. The patient, a 48-year-old male, experienced a burst fracture of the T12 vertebra, leading to compression of the conus medullaris. He underwent surgery, but continued to experience back pain and spasticity. The authors suggest a new technique for analyzing lumbosacral injuries, measuring the injury's location relative to the tip of the conus medullaris. This helps assess upper motor neuron involvement and may predict regeneration time and functional outcomes.

• 1
  A high-riding injury site in CMS, proximal to the tip of the conus medullaris, correlates with a more pronounced clinical presentation of upper motor neuron signs (UMNS).
• 2
  Persistent UMNS and scintigraphy findings (increased uptake on SPECT and bone scan) during follow-up indicate a prolonged recovery period for upper motor neuron injuries in CMS.
• 3
  Measuring the location of injury relative to the tip of the conus medullaris, alongside clinical neurological examination, can help assess the extent of UMN involvement and potentially predict recovery time and functional outcome.