KEY TAKEAWAYS
- The study aimed to evaluate the clinical presentation, diagnosis, treatment, and outcomes of CM metastasis.
- Researchers found that CM metastasis has poor survival despite surgery and combined therapy.
Metastasis to the conus medullaris (CM) is rare but severe. Amr Badary and the team aimed to assess the clinical presentation, diagnostic approach, treatment options, and outcomes of patients with CM metastasis and brain cancer.
The study conducted a systematic review following PRISMA guidelines, analyzing literature on CM metastasis from 1997 to January 2024. The review included human studies published in English, with a focus on primary research articles. Screening criteria were applied to ensure a homogeneous study population. Data analysis was performed using SPSS 26, and the JBI checklist was used for quality assessment.
They included 88 patients with CM metastasis. Back pain (49.3%), sensory impairment (75%), and bladder dysfunction (60.3%) were common symptoms. MRI, the primary diagnostic tool, revealed lesions above L1 (37%) or between L1 and L2 (29%). Treatment involved surgery with laminectomy, and combined therapy (surgery plus radiotherapy) in 81.3% of patients.
Postoperative outcomes showed improved motor function in 59.6% of patients who underwent surgery. Combined therapy resulted in better sensory and bowel/bladder function recovery. The median survival time was 100 days.
The study concluded that while surgical resection can enhance motor function and combined therapy improves sensory and bowel/bladder functions, the median survival for conus medullaris metastasis remains around 100 days, shorter than other intramedullary spinal cord metastases.
Funding information was not available.
Source: https://link.springer.com/article/10.1007/s11060-024-04816-x
Badary A, Kertam A, El-Ramly TA, et al. (2024). “Understanding metastatic involvement of the conus medullaris: a systematic review of clinical presentations, diagnostic approaches, treatment options, and patient outcomes.” J Neurooncol. 2024. doi:10.1007/s11060-024-04816-x.
