Chronic low back pain (LBP) is a condition affecting lumbar portion of the spine for more than 12 weeks or 3 months.

Etiologies can be lumbar or spinal fractures, interspinous ligament injury, fusion hardware tissue irritation from repeated spinal procedures, age or tumor.

Conus medullaris tumor often misconstrued for mechanical lower back pain diagnosis. Conus Medullaris Syndrome (CMS) is compression of the cord by a tumor or traumatic bone fragments, burst fracture, infection, ischemic, or inflammation.

CMS incidence is 1 in 30,000 to 100,000 individuals per year with a total annual prevalence of 1.5 to 3.4 per million people.

Our patient suffered from a schwannoma conus medullaris tumor secondary to conus medullaris syndrome with progressively worsening co-existing chronic mechanical lower back pain misdiagnosed as vascular malformation.