Dr. Samar Fawzy Gad Mohamed :: Publications:

Introduction: The assessment of the position of the conus medullaris is very important in lumbar puncture and surgical procedures. There are some reports about the relationships between the clinical manifestations and the spinal cord morphology in patients with myelopathy. It has also been reported that there are variations in the cross-sectional area of the cervical segments of the spinal cord. Aim: the aim of this study is to compare the levels of conus medullaris in prenatal and postnatal lives and to measure the diameters of the cervical spinal cord segments of healthy individuals. Subjects and methods: this study was conducted on sixty pregnant females (considered as a prenatal group) and one hundred and twenty healthy volunteers (considered as a postnatal group). In the prenatal group, Sonographic evaluation of the conus medullaris (CM) of fetuses was done and the conus distance was measured. In the postnatal group, the T2-weighted MRI was done to record the level of CM. In addition, the transverse and anteroposterior diameter of the cervical spinal cord and the cross sectional area from C2 to T1 at the level of each intervertebral disc were investigated. Results: In the prenatal group, the mean of conus distance was 32.3812.13 mm. The level of the tip of the conus medullaris in the postnatal group showed almost distribution from the T12 to L2- L3 disc. The peak of the distribution of the conus height was at the level of disc between T12-L1. The anteroposterior diameter decreased linearly from C2 to T1.The transverse diameter and the cross sectional area were the largest at the level of C4-C5, and decreased progressively to segment T1. There was no statistically significant difference in relation to sex Conclusions: Linear regression analysis showed a significant correlation between the conus distance and gestational age (GA) and and femur length (FL).. The ascent of conus medullaris seems to occur early in postnatal life. The transverse diameter and the cross sectional area were the largest at the level of C4-C5 while the anteroposterior diameter decreased from C2 to T1.There was no significant correlation between cervical diameters and gender.