What Is Conus Medullaris? Everything You Need to Know

August 9, 2023
Dr Christopher Yeung
BY Christopher A. Yeung, M.D.
Dr. Christopher Yeung is a board-certified, fellowship-trained orthopedic spine surgeon, with a special interest in minimally invasive spine surgery techniques with a philosophy of choosing the least invasive yet most effective method to treat spine problems.

Spinal injuries can be painful and draw your life to a screeching halt. Conus medullaris is a secondary spinal condition that can cause significant pain and other symptoms that affect your quality of life. When the lower end of the spinal cord becomes damaged, it’s possible to develop conus medullaris syndrome and even cauda equina syndrome as an aftereffect.

Learning how to identify the condition and get prompt medical care can help you find relief from your symptoms. Below is everything you need to know about conus medullaris causes and the available treatment options.

What Is Conus Medullaris Syndrome?

The conus medullaris refers to the lower end of the spinal cord that tapers off around the lumbar vertebrae. If you have an injury to this area or experience compressive damage, you could develop conus medullaris syndrome. 

Generally, conus medullaris syndrome doesn’t cause paralysis like other types of spinal injuries. Instead, a person with conus medullaris may experience some of the following symptoms:

  • Extreme back pain
  • Sexual dysfunction
  • Tingling, numbness or weakness in the back
  • Bladder or bowel dysfunctions
  • Jarring or unusual sensations in the back
  • Lower limb sensations not caused by clinical problems

These issues can develop quickly and occur on one or both sides of the body. Even if people with conus medullaris don’t experience the complete range of symptoms, they may have back pain, strange sensations and bowel dysfunctions due to the condition. 

Conus Medullaris Diagnosis

The symptoms listed above don’t always indicate conus medullaris syndrome. However, these concerns typically raise suspicions in medical professionals, indicating a need for additional tests. If your doctor believes you may have conus medullaris, they’ll order MRI testing of your lower back and spine. 

The MRI can detect a spinal cord injury and determine if it’s causing conus medullaris syndrome. Your doctor might also evaluate your muscle strength and reflexes or measure your symptoms on a scale to assess the level and extent of the condition. With thorough screening and symptom analysis, specialists can diagnose you with conus medullaris syndrome and recommend how to proceed with treatment. 

What Causes Conus Medullaris?

Conus medullaris syndrome isn’t a disease that can develop on its own. Instead, it’s the result of a spinal injury or trauma. Some of the most common causes of conus medullaris include the following.

What Causes Conus Medullaris?
  • Trauma: Trauma is the most common cause of conus medullaris. If a person experiences trauma to their lower back — such as gunshot wounds, car accidents or hard blows — they’re more likely to develop conus medullaris as the aftereffect of a spinal injury. Any moderate to severe spinal injury can lead to conus medullaris, so you should seek medical treatment as soon as you notice the signs.
  • Infections: While less common, infections such as meningitis, herpes simplex virus and tuberculosis can all cause conus medullaris if they reach the spine.
  • Herniated discs: People with herniated discs can also develop conus medullaris, since the condition creates spinal trauma. Herniated discs limit the space available for nerve roots, which can cause compressive damage that evolves into conus medullaris.
  • Other spinal conditions: If you have other spinal conditions, such as spinal stenosis, you can develop conus medullaris. Spinal stenosis is a narrowing of the spinal canal that can put more pressure on the nerves. Other conditions, such as tumors, can also cause conus medullaris.

Since conus medullaris typically results from trauma, you must seek medical treatment as soon as possible after a spinal injury. However, you may not notice any symptoms immediately. Once you do, inform your doctor about your medical history. Prompt professional attention is the best way to receive an accurate diagnosis and start treatment to reduce your symptoms and improve your quality of life.

Is Conus Medullaris Treatable?

Once your doctor has determined the condition’s cause after testing, they can recommend the best treatment. Without early intervention, conus medullaris can become more severe and challenging to address, and the focus may shift to symptom management. Some conus medullaris remedies include the following.

  • Spinal decompression surgery: This procedure takes pressure off the different elements in your spine. Surgeons usually perform this treatment if trauma or a spinal injury caused conus medullaris to develop. The process should help relieve pain and other symptoms to improve your quality of life.
  • Antibiotics: Sometimes, a spinal infection can result in conus medullaris syndrome. Antibiotics can combat the infection and alleviate symptoms. Depending on the condition’s severity, your doctor may prescribe antibiotics in combination with other treatments. 
  • Radiation: If a tumor or similar growth has caused conus medullaris syndrome, radiation therapy can be an effective way to find relief. Radiation targets the tumor to remove pressure on the spine, reducing symptoms such as pain or strange sensations. 
  • Physical therapy: Regardless of why you have conus medullaris syndrome, you’ll likely need to participate in physical therapy to regain any stability and stamina you may have lost as a result. If you undergo surgery or radiation to reduce your pain, you could also lose strength in your back and spine. Physical therapy helps you build muscle to support your spine, which can lessen any remaining pain and other symptoms.
  • Pain management: If conus medullaris developed due to another condition, such as spinal stenosis, treatment generally focuses on the primary illness. Your doctor can recommend ways to manage your pain, such as medication or physical activity. 

Contact Desert Institute for Spine Care for Conus Medullaris Treatment

If you or a loved one is dealing with conus medullaris syndrome or suspect you may have the condition, the professional team at DISC is here for you. We are an orthopedic spine center in the greater Phoenix area that uses cutting-edge techniques to help you find relief. We customize treatment to patients’ unique conditions and circumstances. 

We always recommend the least invasive option, enabling many patients to have a shorter, more comfortable recovery. Contact us today to learn more about our treatment options and how we can improve your quality of life.

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