The conus is low-lying (terminating at L4) and associated with a posterior neural arch defect (on the right side) at L5. Through this defect, a fatty mass (high T1, T2 signal, low STIR) is attached to the dorsal aspect of the cord and continuous with the adjacent posterior subcutaneous fat. The filum terminale appears separate from the mass and can be traced as it descends anteriorly to the fatty mass in thecal sac. The lipoma-neural placode interface is seen within the spinal canal, in keeping with a tethered cord with spina bifida and lipomyelocele. Small cord syrinx is also noted along L1 and L2 levels.