CONUS MEDULLARIS

Question 1

CONUS MEDULLARIS classic presentation

Answer 1

• sudden severe back pain
• symmetric lower limb weakness

Question 2

similar DDX’s

Answer 2

• cauda equina
• lumbar facet syndrome
• lumbar disc herniation

Question 3

supporting factors

Answer 3

• trauma at L1-L3
• back pain is more
• severe than radicular pain
• present suddenly and bilateral
• numbness and weakness in lower limb

Question 4

refuting factors

Answer 4

• LMN findings
• unilateral
• abnormal patella reflex

Question 5

relevant findings

Answer 5

• dejerines triad
• valsava’s

Question 6

referrals

Answer 6

• x-rays
• MRI
• immediate ER for bowel and bladder function

Question 7

contraindications

Answer 7

• no adjusting until cleared by GP

Question 8

technique

Answer 8

• activator (after cleared)

Question 9

care plan

Answer 9

• no care until cleared by GP
• after clear 2 x a week for 3 weeks

Question 10

technique

Answer 10

• activator (after cleared)

Question 11

contraindications

Answer 11

• no adjusting until cleared

Question 12

recommendations

Answer 12

• gentle exercise
• stretching
• non-inflammatory diet

Question 13

prognosis

Answer 13

• if its bilateral (severe case)
• recovery is slow after surgery

Question 14

questions to ask

Answer 14

• do you notice these symptoms on one side or both
• have you noticed bowel changes
• is your back pain worse than radicular pain