- The sacral cord segments end at the L1/L2 vertebral level forming the conus medullaris whereupon descending spinal nerves continue on as the caudal equna below the level of L1/2 (one vertebrae lower in young children)
- Rookie hint: if the vertebral pathology is below L2, there can’t be a cord lesion
- This part of the cord contributes to the parasympathetic outflow tract and innervates the pelvic organs
- Cutaneous Sensory function innervates the perineal region (hence abnormalities
- Visceromotor and viscerosensory function controls important functions such as micturition, defaecation and sexual function (the embryonic cloaca)
Clinical assessment
- History of urinary or faecal incontinence or retention
- Sensory – perineal sensation (‘saddle anaesthesia’), urethral sensation tested tested by gently tugging on IDC
- Motor – loss of anal tone