What are the most common causes of cauda equina and conus medullaris syndromes?

Updated: Jun 14, 2018
  • Author: Segun Toyin Dawodu, JD, MD, MS, MBA, LLM, FAAPMR, FAANEM; Chief Editor: Nicholas Lorenzo, MD, CPE, MHCM, FAAPL  more...
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The most common causes of cauda equina and conus medullaris syndromes are the following:

  • Lumbar stenosis (multilevel)

  • Spinal trauma including fractures [16]

  • Herniated nucleus pulposus (cause of 2-6% of cases of cauda equina syndrome) [17, 18, 19]

  • Neoplasm, including metastases, astrocytoma, neurofibroma, and meningioma; 20% of all spinal tumors affect this area

  • Spinal infection/abscess (eg, tuberculosis, herpes simplex virus, meningitis, meningovascular syphilis, cytomegalovirus, schistosomiasis) [20]

  • Idiopathic (eg, spinal anesthesia [21] ): these syndromes may occur as complications of the procedure or of the anesthetic agent (eg, hyperbaric lidocaine, tetracaine)

  • Spina bifida and subsequent tethered cord syndrome [22]

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