Intramedullary Lesions of the Conus Medullaris: Differential Diagnosis and Surgical Management
Overview
Affiliations
The medullary conus represents a distinct entity of the spinal cord regarding its anatomical, clinical and microsurgical features. An overview of the pathologic processes of this region is provided. Epidemiological, clinical and neuroradiological characteristics of neoplastic (glial tumors, non-glial tumors, metastasis, primary melanomas) and non-neoplastic lesions (granulomatous lesions, abscess, parasitic infections, vascular, demyelinating and dysembryogenetic lesions) are discussed. Main MR imaging characteristics used to differentiate neoplastic from non-neoplastic lesions consist in pathological spinal cord expansion, gadolinium-enhancement and tumoural cyst formation. Management strategies differ substantially, depending on the kind of lesion. According to the suspected pathological entity radical resection, biopsy or conservative treatments are reasonable options. Intraoperative electrophysiological monitoring is a fundamental part of the surgical setting.
Escobar-Moreno J, Ramirez-Loera C, Duran-Villalobos A, Reyes Navarro D, Ruiz-Trevino A Cureus. 2025; 16(12):e75177.
PMID: 39759749 PMC: 11700527. DOI: 10.7759/cureus.75177.
Intramedullary Epidermoid Cyst of the Conus Medullaris: A Case Report and Literature Review.
Hussen E, Aboye S, Leake M, Abrar F Int Med Case Rep J. 2023; 16:521-527.
PMID: 37720363 PMC: 10505022. DOI: 10.2147/IMCRJ.S430853.
Alfin J, Akpa P, Shilong D, Bot G, Nwibo O, Kyesmen N J West Afr Coll Surg. 2023; 13(2):113-117.
PMID: 37228891 PMC: 10204907. DOI: 10.4103/jwas.jwas_201_22.
Acute Venous Congestive Myelopathy in a Patient with Neurosarcoidosis.
Guy N J Neurol Surg Rep. 2022; 83(3):e119-e122.
PMID: 36188492 PMC: 9522485. DOI: 10.1055/a-1929-5265.
Kweh B, Roberts-Thomson S, Verhellen T, Nair G J Neurosurg Case Lessons. 2022; 2(6).
PMID: 36131574 PMC: 9589475. DOI: 10.3171/CASE21323.