[Tumor compression of the conus and cauda]

The author analyzed a group of 17 patients with spinal tumours with symptoms of compression of the conus or cauda. Early clinical symptoms were sought and the entire clinical course before surgery was evaluated. The objective clinical finding was compared with the surgical one. Causes of diagnostic errors were analyzed. Most frequently a discogenic or other vertebrogenic cause of complaints was suspected. In all patients a local or root symptoms were the first manifestation of the disease. From the investigation ensues that a tumour must be considered when pain radiates into both lower extremities, in case of striking stiffness of the spine up to the neck and in case of damage of the higher lumbar roots. Tumours are more frequently located higher than prolapsed discs with manifestations of caudal compression. When bone structures are affected in primary tumours, the objective clinical finding may be very sparse. Tumours at the borderline of Th-L may be manifested by root symptoms L5 or S1. During PMG attention is focused lower, usually a prolapsed disc of L4/5 or L5/S1 is suspected and the tumour may be missed. Values of cerebrospinal fluid proteins in fluid collected at the lumbar level were high in all patients of the group.