Cone syndrome

The spinal conus is formed by the most distal part of the spinal cord, just before the transition of the spinal cord in the cauda equina. The cone is practically completely hidden behind the lower part of the body of the L1 vertebra and the L1/L2 intervertebral disc. overview|The spinal conus is located just above the transition of the spinal cord in the cauda equina Spinal conus syndrome is compression of the spinal cord in the S3–S5 region.

The cone of the spinal cord is supplied vascularly from the epicon. Epicon syndrome is often accompanied by conus syndrome.

Etiology

Cone syndrome is rare, and is most often caused by an intramedullary tumor, further metastatic spread, traumatic involvement of the L1 or L2 vertebrae, or a disorder of the blood supply to the spinal cord due to involvement of the lower radicular artery.

The spinal conus is located just above the junction of the spinal cord in the cauda equina

Clinical picture

• Sphincter disorders dominate – the main manifestation of Kon syndrome is urinary and stool incontinence, i.e. bladder sphincters and anal sphincters are affected, together with the absence of the anal reflex, erectile dysfunction and impotence
• There is no obvious motor deficit - the muscles of the pelvic outlet and the small flexors of the fingers are affected, other mobility in the lower limbs is preserved.
• Sensory impairment (hypesthesia) is perianogenital (saddle-shaped) – it affects the perineum area, the upper third of the inner thighs, the distal parts of both buttocks, it is mostly symmetrical and sometimes dissociated. In addition to hyp- or anesthesia, spontaneous pain can sometimes appear in the perineum area of the lower part of the buttocks.

Links

Related articles

• Cauda syndrome
• Epicon syndrome
• Traumatic spinal cord syndromes

Reference

•  Neurologická klinika 1. LF UK a VFN v Praze. Neurologie – E-learning [online]. [cit. 2014-02-07]. <https://www.neuro.lf1.cuni.cz/vyuka/index.php?page=edu_elearning>.

References

• NEVŠÍMALOVÁ, Soňa – RŮŽIČKA, Evžen – TICHÝ, Jiří. Neurologie. 1. edition. Galén, 2002. 0 pp. ISBN 80-7262-160-2.

•  AMBLER, Zdeněk. Základy neurologie. 6. edition. Galén, 2006. ISBN 80-7262-433-4.