The epiconus syndrome presenting radicular-type neurological features

Willems, J.; Chappel, R

doi:10.1038/sj.sc.3100511

Cited by 4 publications

(6 citation statements)

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“…On the other hand, we found that half of our patients in the whole group or in each single fracture group, had epiconus and lumbar roots lesions. Patients who have this kind of injuries showed flaccidity of quadriceps To the best of our knowledge, there have been few reports in the related literature that mention these clinical events [14]. Spinal root injuries have a better prognosis for recovery than spinal cord injuries.…”

Section: Discussionmentioning

confidence: 96%

“…Spinal root injuries have a better prognosis for recovery than spinal cord injuries. This is most likely because the rootlets are more mobile than cord, with nerve roots being more resilient to injury, and because many of the biochemical processes that occur in the spinal cord may produce secondary damage [14]. The LEMS of group A patients was numerically lower than group B and C, however, this was not statistically significant.…”

Section: Discussionmentioning

confidence: 97%

“…Conus medullaris lesions, which affect neural segments S2 and below, present with LMN deficits of the bladder and sphincter. Injuries of cauda equina, which includes lumbar and sacral root, will cause LMN deficits of legs, feet, bladder, and sphincter [14].…”

Section: Discussionmentioning

confidence: 99%

“…The conus medullaris, which is the terminal segment of the adult spinal cord, lies at the L1 vertebra for most adults. The segment above the conus medullaris is termed the epiconus and consists of spinal cord segments L4 through S1 [13,14]. Lesions of the epiconus affect the lumbar cord and the roots supplying muscles of legs and feet, with sparing of reflex function of sacral segments.…”

Section: Discussionmentioning

confidence: 99%

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Motor and bladder dysfunctions in patients with vertebral fractures at the thoracolumbar junction

et al. 2011

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Half of the patients had epiconus lesion following thoracolumbar junction fracture, and they had a clinical presentation of flaccid legs and spastic NBD. Patients with L2 fracture had higher LEMS than patients with T11, T12, and L1 fracture. Patients whose LEMS was higher than 20 could all walk functionally. Fracture at the thoracolumbar junction may cause spastic, flaccid, or mixed type NBD, and urodynamic study is an essential tool for the correct diagnosis and management. Ankle spasticity has a high positive predictive value for spastic bladder or sphincter.

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Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Motor and bladder dysfunctions in patients with vertebral fractures at the thoracolumbar junction

et al. 2011

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“…The segment above the conus medullaris is termed the epiconus and consists of spinal cord segments L4 through S1; conus medullaris lesions affect neural segments S2 and below; injuries of cauda equina affect lumbar and sacral roots. Injuries at epiconus lesion result in upper motor neuron deficits of bladder sphincter, but injuries at conus medullaris and cauda equina can cause lower motor neuron deficits of bladder dysfunction [21]. All eight cases in this study were injured at L1 level.…”

Section: Discussionmentioning

confidence: 77%

Surgical outcomes in thoracolumbar fractures with pure conus medullaris syndrome

Chiu

Liao

2019

Biomedical Journal

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BackgroundPure conus medullaris syndrome is defined as a combination of signs and symptoms of bladder/bowel incontinence and impotence without the presence of lower limbs weakness. The purpose of the study is to assess the recovery of voiding, sexual, and sensory function in patients with isolated conus medullaris syndrome after surgical treatments.MethodsFrom January 2005 to December 2012, patients with a single level burst fracture with pure conus medullaris syndrome were assessed. Level of injury, use of steroid, surgical time, surgical approach, preoperative radiographic parameters, and types of neurogenic bladder were recorded. Bladder function was evaluated using urodynamic study; sexual function was assessed by self-report questionnaire. The final outcomes were focused on the recovery of voiding, sexual, and sensory function.ResultsEight patients met the criteria of pure conus medullaris syndrome with thoracolumbar burst fracture. The injury level were all located at L1 vertebra. There were 6 males and 2 females. Four patients had overactive neurogenic bladder, and the other 4 patients had underactive type. At final, five patients regained self-voiding function, and three required intermittent catheterization. Two male patients were sexually active, and four male patients had some sexual dysfunction. Two female patients could have normal sexual intercourse but the frequency decreased. One female patients had prolonged perineum numbness at final follow-up.ConclusionsAlthough extremely rare, pure conus medullaris syndrome may occur with L1 burst fracture. Despite surgical treatment, only one half of the patients regained normal bladder and sexual function.

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Does an intraoperative finding of an intact dural sac help to prognosticate neurological recovery in cauda equinal and epiconal injuries in thoracolumbar fractures? An analysis of 31 patients

Varma¹

2014

Eur Spine J

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The epiconus syndrome presenting radicular-type neurological features

Cited by 4 publications

References 0 publications

Motor and bladder dysfunctions in patients with vertebral fractures at the thoracolumbar junction

Motor and bladder dysfunctions in patients with vertebral fractures at the thoracolumbar junction

Surgical outcomes in thoracolumbar fractures with pure conus medullaris syndrome

Does an intraoperative finding of an intact dural sac help to prognosticate neurological recovery in cauda equinal and epiconal injuries in thoracolumbar fractures? An analysis of 31 patients

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