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The Importance of the Acute and Subacute Interdisciplinary Management of a Patient with Conus Medullaris Syndrome: Case Report

Received: 16 December 2021    Accepted: 6 January 2022    Published: 10 May 2022
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Abstract

Background: One of the main components in spinal cord injury´s management lies in the early and adequate interventions, as well as the possible outcomes considering the time from the trauma to every step afterwards. This case reports the course of action taken in an adult previously healthy that was diagnosed with conus medullaris syndrome because of falling from a considerable height. Intraoperative Monitoring can help us to look after the early changes that may occur in surgical correction and allows giving prognostic value to neurophysiological changes that will affect the patient's quality of life. Diagnostic images are also essential for a proper surgical approach, and an adequate follow-up of the patient. All these tools facilitate the rehabilitation treatment, in whom our final objective will be to achieve the best global functionality. Objective: Based on a case, we seek to describe the importance of the acute and subacute interdisciplinary management of a patient with Conus Medullaris Syndrome. Methods: Case report, the information was extracted from the medical history. Results: The result was positive due to the fast and adequate response given from a first level health center to the operation room and the rehabilitation phase. Conclusion: An adequate interdisciplinary conduct approaches each individual with specific and realistic objectives, with continuous assessments and always considering the possible progressions and/or variations of the patient’s state. Explaining the complications inherent to the surgical and non-surgical component, for an optimal result according to the conditions and resources available.

Published in European Journal of Clinical and Biomedical Sciences (Volume 8, Issue 3)
DOI 10.11648/j.ejcbs.20220803.11
Page(s) 33-37
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Cauda Equina, Conus Medullaris Syndrome, Traumatic Spinal Cord Injury, Electrodiagnostic

References
[1] Brouwers E, Van De Meent H, Curt A, Starremans B, Hosman A, Bartels R. Definitions of traumatic conus medullaris and cauda equina syndrome: A systematic literature review. Spinal Cord [Internet]. 2017; 55 (10): 886–90. Available from: http://dx.doi.org/10.1038/sc.2017.54
[2] Sánchez JAS, Sharif S, Costa F, Rangel JAIR, Anania CD, Zileli M. Early management of spinal cord injury: WFNS spine committee recommendations. Neurospine. 2020; 17 (4): 759–84.
[3] Abdul Azeez MM, Moscote-Salazar LR, Alcala-Cerra G, García-Ballestas E, Bustos-Salazar D, Satyarthee GD, et al. Emergency Management of Traumatic Spinal Cord Injuries. Indian J Neurotrauma. 2020; 17 (02): 057–61.
[4] Bennett J, M Das J, Emmady P. Spinal Cord Injuries. StatPearls [Internet]. 2021; Available from: https://www.ncbi.nlm.nih.gov/books/NBK560721/
[5] María A, Sánchez G, María L, Posada G, Andrés C, Toscano O, et al. EnfoquE diagnóstiCo dE las miElopatías diagnostiC appRoaCh to myElopathiEs. artículos revisión Rev Colomb Radiol. 2011; 22 (3): 3231–51.
[6] Harrop JS, Hunt GE, Vaccaro AR. Conus medullaris and cauda equina syndrome as a result of traumatic injuries: management principles. Neurosurg Focus. 2004; 16 (6): 19–23.
[7] Kalindemirtas M, Orhan M, et al. Examination of the Level of Conus Medullaris Termination Using Magnetic Resonance Imaging. Eur J Ther. 2021; 27 (2): 123–34.
[8] Rider IS, Marra EM. Cauda Equina and Conus Medullaris Syndromes. StatPearls [Internet]. 2018; (May). Available from: http://www.ncbi.nlm.nih.gov/pubmed/30725885
[9] Goldberg AL, Kershah SM. Advances in imaging of vertebral and spinal cord injury. J Spinal Cord Med. 2010; 33 (2): 105–16.
[10] Eldaya R, Eissa O, Calles G, Lee-Diaz J, Uribe T. MRI of Conus Medullaris, Cauda Equina, and Filum Terminale Lesions. Contemp Diagnostic Radiol. 2016; 39 (24): 1–7.
[11] Qadir I, Riew KD, Alam SR, Akram R, Waqas M, Aziz A. Timing of Surgery in Thoracolumbar Spine Injury: Impact on Neurological Outcome. Glob Spine J. 2020; 10 (7): 826–31.
[12] Chiu PY, Liao JC. Surgical outcomes in thoracolumbar fractures with pure conus medullaris syndrome. Biomed J [Internet]. 2019; 42 (4): 277–84. Available from: https://doi.org/10.1016/j.bj.2019.02.004
[13] Gonzalez AA, Jeyanandarajan D, Hansen C, Zada G, Hsieh PC. Intraoperative neurophysiological monitoring during spine surgery: A review. Neurosurg Focus. 2009; 27 (4): 1–10.
[14] Aydinlar EI, Dikmen PY, Kocak M, Baykan N, Seymen N, Ozek MM. Intraoperative Neuromonitoring of Motor-Evoked Potentials in Infants Undergoing Surgery of the Spine and Spinal Cord. J Clin Neurophysiol. 2019; 36 (1): 60–6.
[15] Tsutsui S, Iwasaki H, Yamada H, Hashizume H, Minamide A, Nakagawa Y, et al. Augmentation of motor evoked potentials using multi-train transcranial electrical stimulation in intraoperative neurophysiologic monitoring during spinal surgery. J Clin Monit Comput. 2015; 29 (1): 35–9.
[16] Park J-H. Intraoperative neurophysiological monitoring in spinal surgery. World J Clin Cases. 2015; 3 (9): 765.
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Cite This Article
  • APA Style

    Salim Torres Yamil Yasser, Linares Mora Ricardo Andrés, Sánchez Parra Pedro Santiago, Campo Álvarez Jessica Paola. (2022). The Importance of the Acute and Subacute Interdisciplinary Management of a Patient with Conus Medullaris Syndrome: Case Report. European Journal of Clinical and Biomedical Sciences, 8(3), 33-37. https://doi.org/10.11648/j.ejcbs.20220803.11

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    ACS Style

    Salim Torres Yamil Yasser; Linares Mora Ricardo Andrés; Sánchez Parra Pedro Santiago; Campo Álvarez Jessica Paola. The Importance of the Acute and Subacute Interdisciplinary Management of a Patient with Conus Medullaris Syndrome: Case Report. Eur. J. Clin. Biomed. Sci. 2022, 8(3), 33-37. doi: 10.11648/j.ejcbs.20220803.11

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    AMA Style

    Salim Torres Yamil Yasser, Linares Mora Ricardo Andrés, Sánchez Parra Pedro Santiago, Campo Álvarez Jessica Paola. The Importance of the Acute and Subacute Interdisciplinary Management of a Patient with Conus Medullaris Syndrome: Case Report. Eur J Clin Biomed Sci. 2022;8(3):33-37. doi: 10.11648/j.ejcbs.20220803.11

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  • @article{10.11648/j.ejcbs.20220803.11,
      author = {Salim Torres Yamil Yasser and Linares Mora Ricardo Andrés and Sánchez Parra Pedro Santiago and Campo Álvarez Jessica Paola},
      title = {The Importance of the Acute and Subacute Interdisciplinary Management of a Patient with Conus Medullaris Syndrome: Case Report},
      journal = {European Journal of Clinical and Biomedical Sciences},
      volume = {8},
      number = {3},
      pages = {33-37},
      doi = {10.11648/j.ejcbs.20220803.11},
      url = {https://doi.org/10.11648/j.ejcbs.20220803.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ejcbs.20220803.11},
      abstract = {Background: One of the main components in spinal cord injury´s management lies in the early and adequate interventions, as well as the possible outcomes considering the time from the trauma to every step afterwards. This case reports the course of action taken in an adult previously healthy that was diagnosed with conus medullaris syndrome because of falling from a considerable height. Intraoperative Monitoring can help us to look after the early changes that may occur in surgical correction and allows giving prognostic value to neurophysiological changes that will affect the patient's quality of life. Diagnostic images are also essential for a proper surgical approach, and an adequate follow-up of the patient. All these tools facilitate the rehabilitation treatment, in whom our final objective will be to achieve the best global functionality. Objective: Based on a case, we seek to describe the importance of the acute and subacute interdisciplinary management of a patient with Conus Medullaris Syndrome. Methods: Case report, the information was extracted from the medical history. Results: The result was positive due to the fast and adequate response given from a first level health center to the operation room and the rehabilitation phase. Conclusion: An adequate interdisciplinary conduct approaches each individual with specific and realistic objectives, with continuous assessments and always considering the possible progressions and/or variations of the patient’s state. Explaining the complications inherent to the surgical and non-surgical component, for an optimal result according to the conditions and resources available.},
     year = {2022}
    }
    

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  • TY  - JOUR
    T1  - The Importance of the Acute and Subacute Interdisciplinary Management of a Patient with Conus Medullaris Syndrome: Case Report
    AU  - Salim Torres Yamil Yasser
    AU  - Linares Mora Ricardo Andrés
    AU  - Sánchez Parra Pedro Santiago
    AU  - Campo Álvarez Jessica Paola
    Y1  - 2022/05/10
    PY  - 2022
    N1  - https://doi.org/10.11648/j.ejcbs.20220803.11
    DO  - 10.11648/j.ejcbs.20220803.11
    T2  - European Journal of Clinical and Biomedical Sciences
    JF  - European Journal of Clinical and Biomedical Sciences
    JO  - European Journal of Clinical and Biomedical Sciences
    SP  - 33
    EP  - 37
    PB  - Science Publishing Group
    SN  - 2575-5005
    UR  - https://doi.org/10.11648/j.ejcbs.20220803.11
    AB  - Background: One of the main components in spinal cord injury´s management lies in the early and adequate interventions, as well as the possible outcomes considering the time from the trauma to every step afterwards. This case reports the course of action taken in an adult previously healthy that was diagnosed with conus medullaris syndrome because of falling from a considerable height. Intraoperative Monitoring can help us to look after the early changes that may occur in surgical correction and allows giving prognostic value to neurophysiological changes that will affect the patient's quality of life. Diagnostic images are also essential for a proper surgical approach, and an adequate follow-up of the patient. All these tools facilitate the rehabilitation treatment, in whom our final objective will be to achieve the best global functionality. Objective: Based on a case, we seek to describe the importance of the acute and subacute interdisciplinary management of a patient with Conus Medullaris Syndrome. Methods: Case report, the information was extracted from the medical history. Results: The result was positive due to the fast and adequate response given from a first level health center to the operation room and the rehabilitation phase. Conclusion: An adequate interdisciplinary conduct approaches each individual with specific and realistic objectives, with continuous assessments and always considering the possible progressions and/or variations of the patient’s state. Explaining the complications inherent to the surgical and non-surgical component, for an optimal result according to the conditions and resources available.
    VL  - 8
    IS  - 3
    ER  - 

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Author Information
  • Physical Medicine and Rehabilitation, Medicine Faculty, Military University of New Granada, Bogotá, Colombia

  • Physical Medicine and Rehabilitation, Medicine Faculty, Military University of New Granada, Bogotá, Colombia

  • Physical Medicine and Rehabilitation, Medicine Faculty, Military University of New Granada, Bogotá, Colombia

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