Location
Philadelphia, PA
Start Date
10-5-2021 12:00 AM
End Date
13-5-2021 12:00 AM
Description
Objective: The primary objective of this study was to determine the termination level of the spinal cord in a sample population of adult female cadavers.
Introduction: The conus medullaris represents the tapered, distal-most end of the spinal cord. It tends to be found somewhere between the L1-L2 lumbar vertebrae and can sometimes be higher or lower. Studies report the conus medullaris can be found anywhere from the lower third of T11 to the upper third of L3 with the average termination point around the lower third of L1. We aim to describe the level of conus medullaris termination in a sample of female cadavers.
Methods: Twenty-four female cadavers were dissected as part of the Doctor of Osteopathic Medicine curriculum at the Philadelphia College of Osteopathic Medicine. The end of the conus medullaris was defined as the point where tapering ends distal to the last branches of the posterior nerve rootlets. Using the articulation of the 12th rib as a landmark the termination of the conus medullaris was noted to be either at the level of an intervertebral disc or vertebral body. In the latter cases the vertebral body was divided into upper, middle, and lower thirds.
Results: Conus Medullaris termination ranged from the T12-L1 intervertebral disc to the L2-L3 intervertebral disc. The L1-L2 intervertebral disc was the most common termination point with 42% of cadavers demonstrating spinal cord termination at this level.
Conclusions: These results demonstrate that there is variation of spinal cord termination, which can play a role in lumbar punctures, spinal anesthesia, and obstetric anesthesia. Due to the risk of cord damage it is imperative to perform any sort of anesthetic procedure fully below the level of L3 in the L3-L4 space or L4-L5 space. An epidural injection above the level of L3 may cause severe spinal cord damage if there is dural puncture and an anatomical variant in which the conus medullaris extends to the L3 level.
Embargo Period
6-2-2021
Conus medullaris termination in adult females
Philadelphia, PA
Objective: The primary objective of this study was to determine the termination level of the spinal cord in a sample population of adult female cadavers.
Introduction: The conus medullaris represents the tapered, distal-most end of the spinal cord. It tends to be found somewhere between the L1-L2 lumbar vertebrae and can sometimes be higher or lower. Studies report the conus medullaris can be found anywhere from the lower third of T11 to the upper third of L3 with the average termination point around the lower third of L1. We aim to describe the level of conus medullaris termination in a sample of female cadavers.
Methods: Twenty-four female cadavers were dissected as part of the Doctor of Osteopathic Medicine curriculum at the Philadelphia College of Osteopathic Medicine. The end of the conus medullaris was defined as the point where tapering ends distal to the last branches of the posterior nerve rootlets. Using the articulation of the 12th rib as a landmark the termination of the conus medullaris was noted to be either at the level of an intervertebral disc or vertebral body. In the latter cases the vertebral body was divided into upper, middle, and lower thirds.
Results: Conus Medullaris termination ranged from the T12-L1 intervertebral disc to the L2-L3 intervertebral disc. The L1-L2 intervertebral disc was the most common termination point with 42% of cadavers demonstrating spinal cord termination at this level.
Conclusions: These results demonstrate that there is variation of spinal cord termination, which can play a role in lumbar punctures, spinal anesthesia, and obstetric anesthesia. Due to the risk of cord damage it is imperative to perform any sort of anesthetic procedure fully below the level of L3 in the L3-L4 space or L4-L5 space. An epidural injection above the level of L3 may cause severe spinal cord damage if there is dural puncture and an anatomical variant in which the conus medullaris extends to the L3 level.