Spinal cord syndromes

Cauda equina syndrome

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Sphincter dysfunction

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근력 약화를 동반한 부분 마비 (multiple root distribution)

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Sensory loss in multiple bilateral dermatomes

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Extrinsic tumor

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Carcinomatous meningitis

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Arachnoiditis

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Spinal stenosis

Conus medularis syndrome

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Lower sacral saddle sensory loss (S2-S5)

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Sphincter dysfunction : impotence

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쑤시는 듯한 Back/rectal pain

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L5 and S1 motor deficits (ankle과 foot weakness)

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Intricsic tumor

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Extrinsic cord compression

Table 1. Symptoms and Signs of Conus Medullaris and Cauda Equina Syndromes

	Conus Medullaris Syndrome	Cauda Equina Syndrome
척추 레벨	L1-L2	L2-sacrum
척수 레벨	sacral cord segment (conus and epiconus) 와 roots의 손상	Ilumbosacral nerve roots의 손상
증상발현	갑자기, 양측성	점진적, 단측성
반사	Knee jerks preserved ankle jerks affected Areflexic lower extremities (If the epiconus is involved, patellar reflex may be absent, whereas bulbocavernosus reflex may be spared.)	Both ankle and knee jerks affected Areflexic lower extremities; bulbocavernosus reflex is absent in low CE (sacral) lesions
증상과 징후의 심각성	대개 심각하지 않음	대개 심각함
증상과 징후의 대칭성	대개 대칭적	대개 비대칭적
통증	대개 항문주위에 양측성 통증	Prominent, asymmetric, and radicular
Radicular pain	덜 심각함	심함
요통	더 심함	덜 심함
감각 증상과 징후	감각저하 증상은 항문주위에 좀더 국한됨; 대칭적이고 양측성 ; sensory dissociation occurs 대칭적 saddle distribution Pin prik / 온도 감각 저하 촉각은 보전	감각저하증상은 saddle area에 좀 더 국한됨; 비대칭적, 단측성일 수 있음. ; no sensory dissociation; 하지의 특정 dermatome에 감각둔마 및 저림 페니스나 클리토리스를 포함한 pubic area에 감각저하 가능 Saddle anesthesia, may be asymmetric
근력	전형적으로 대칭적인 hyperreflexic distal paresis of lower limbs that is less marked; fasciculations may be present 정상적 또는 경증~중등증의 위약	비대칭적 areflexic paraplegia that is more marked; fasciculations rare; atrophy more common Weakness to flaccid paralysis (상당한 근력저하)
발기부전	흔하다	덜 흔하다; erectile dysfunction that includes inability to have erection, inability to maintain erection, lack of sensation in pubic area (including glans penis or clitoris), and inability to ejaculate
괄약근 기능	Urinary retention and atonic anal sphincter cause overflow urinary incontinence and fecal incontinence; tend to present early in course of disease Early and severe bowel, bladder, and sexual dysfunction that results in a reflexic bowel and bladder with impaired erection in males	Urinary retention; tends to present late in course of disease Usually late and of lesser magnitude; lower sacral roots involvement can cause bladder, bowel, and sexual dysfunction
EMG	Mostly normal lower extremity with external anal sphincter involvement	Multiple root level involvement; sphincters may also be involved
Outcome	The outcome may be less favorable than in patients with CES	May be favorable compared with conus medullaris syndrome