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Conus medullaris syndrome and cauda equina syndrome are relatively rare, yet serious health conditions. They are caused by compression of neural structures in the lumbar spinal canal. They are most frequently caused by spinal disc herniation, trauma, iatrogenic injury and neoplasms. Because of their specific anatomic structure and location, the symptoms are complex and do not only result in lumbar pain, but often also in bladder and intestinal incontinence as well as impotence. To establish a correct diagnosis, we usually need thorough patient history, together with the neurologic status and imaging diagnostics, the latter mostly in the form of magnetic resonance imaging. Depending on the symptoms and the speed of their onset, patient care should be urgent or at least provided within reasonable time. In the end, patient prognosis is mostly dependent on etiology as well as establishing a quick and correct diagnosis.