Study of the effects of flexion on the position of the conus medullaris.

Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery
David F BauerR Shane Tubbs

Abstract

Previous anatomic studies have shown the conus medullaris to terminate between T12 and L1 vertebral levels in adults with normal spinal anatomy. Prior anatomic and radiographic studies of conus position with flexion and extension of the spine have had conflicting results. We performed a cadaveric study with direct visualization of the conus during flexion and extension to further study this question and potentially determine if flexion and extension of the spine during magnetic resonance imaging may prove to be a diagnostic tool in such pathologies as occult tethered cord syndrome. We performed T12 to L3 laminectomies in five fresh adult cadavers and exposed the conus and cauda equina. Cadavers were fully flexed at the waist and neck and the conus position observed. In all specimens, the conus terminated between T12 and L1 in the prone position. During flexion, the conus position remained stable with no ascent. However, flexion produced stretching and medial displacement of the cauda equina. Flexion of the spine does not cause the conus medullaris to change position in fresh human cadavers; however, flexion does cause the cauda equina to stretch and displace medially over the conus. Therefore, it is unlikely that the conus woul...Continue Reading

References

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Feb 4, 2006·Cell Transplantation·Sharon A SwangerItzhak Fischer
Jan 5, 2007·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·R Shane TubbsW Jerry Oakes

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Citations

Mar 28, 2009·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·David F BauerM Rene Chambers
May 24, 2011·Journal of Neurosurgery. Spine·Jörg Klekamp
Oct 4, 2011·Journal of Neurosurgery. Pediatrics·Albert H KimEdward R Smith
May 31, 2011·Forensic Science International : Synergy·W SquierC Smith
Feb 27, 2019·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·Vivek YedavalliTarik F Massoud
Jan 17, 2017·Surgical and Radiologic Anatomy : SRA·An LiuJeffrey C Wang
Jul 25, 2021·Journal of Clinical Medicine·Hiroaki NakashimaShiro Imagama

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