Cauda Equina and Conus Medullaris Lesions

The neurological structures associated with traumatic cauda equina and conus medullaris injuries which are resulted from the thoracolumbar spine injuries, differ significantly from those structures that are injured in cervical and thoracic spinal cord injuries. As the thoracolumbar spine is also where the distal spinal cord or epiconus, conus medullaris, and cauda equina are in close proximity, management decisions and prognosis should consider the unique variation in the injured neuroanatomical structures. It is unlikely that the cervical and the majority of the thoracic spine where the spinal column level and the neurological segment are in close proximity, in the thoracolumbar region, there is a profound disparity between the spinal column level and the spinal cord segment. The conus medullaris is condensed to less than two vertebral heights. The conus medullaris is located from the T12–L1 intervertebral disc space to the L1–L2 intervertebral disc space. Within this short distance, approximately ten spinal cord segments, L1–S5, are concentrated in the conus medullaris and are not in close spatial relationship to the respective vertebrae.