Abstract Background Spontaneous conus medullaris infarction is a rare disease. We describe two patients with spontaneous conus medullaris infarction presenting as acute cauda equina syndrome and their unique electromyography (EMG) findings. Case presentation Two patients developed acute low back pain with mild asymmetric paraparesis. loss of perianal sensation and sphincter dysfunction. https://fitnessgravesyardes.shop/product-category/coax-splitter/