Acute Conus Medullaris Syndrome Following Minimally Invasive Lumbar Discectomy: A Case Report with Narrative Review

Authors

  • Bilal Ibrahim
  • Bilal Ibrahim
  • Abdallah Arabyat
  • Mohammad Y. Hiasat
  • Mustafa Nadi
  • Waleed F. Dabbas

Abstract

Introduction:Lumbar disc herniation is a common cause of low back pain, often managed surgically via discectomy. While generally safe, discectomy may result in rare but serious complications such as conus medullaris syndrome (CMS). Most reported cases of CMS develop days to months postoperatively due to mechanical compression or vascular anomalies. Immediate-onset CMS without radiological abnormalities is exceptionally rare.

Case Presentation:We report the case of a 43-year-old man who developed acute CMS following an uneventful L3/L4 tubular microdiscectomy that occurred within hours. The symptoms were bilateral foot drop, saddle anesthesia and urinary retention. On urgent MRI, the conus medullaris was free of any compressive lesions or signal changes. Clinical follow-up showed a dramatic improvement in neurological status of the patient.


Conclusion:This case provides evidence to transient microvascular ischemia that may be involved in acute CMS presentation without radiologic abnormalities. Prompt clinical identification, use of perfusion imaging, and hemodynamic support may enhance outcomes in similar presentations.

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References

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Published

2025-10-25

How to Cite

1.
Ibrahim B, Ibrahim B, Arabyat A, Y. Hiasat M, Nadi M, F. Dabbas W. Acute Conus Medullaris Syndrome Following Minimally Invasive Lumbar Discectomy: A Case Report with Narrative Review. J Neonatal Surg [Internet]. 2025Oct.25 [cited 2025Oct.26];14(32S):9109-14. Available from: https://www.jneonatalsurg.com/index.php/jns/article/view/9382

Issue

Vol. 14 No. 32S (2025): Journal of Neonatal Surgery

Section

Original Article

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Copyright (c) 2025 Bilal Ibrahim, Bilal Ibrahim, Abdallah Arabyat, Mohammad Y. Hiasat, Mustafa Nadi, Waleed F. Dabbas

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