Presentation
Disturbance of bladder function.
Patient Data
Widening of the bony spinal canal from L3 to S2 due to dural ectasia.
No spinal canal stenosis or cord compression.
The spinal cord has normal signal and morphology along the spinal canal.
The conus medullaris terminates at a lower position, at the level of S1/S2.
There are no signs of myelomeningocele.
The vertebral bodies have normal alignment, height, and bone marrow signal.
Intervertebral discs are normal and the intervertebral foramina are capacious.
Case Discussion
Tethered cord syndrome typically arises from closed spinal dysraphisms found in various types of spinal lipomas (including lipomyelomeningocele, conus lipoma, and filar lipoma), as well as from a constricted filum terminale (with or without filar lipoma).
Symptoms increase with age. Differential lengthening of the torso relative to the spinal cord normally causes the conus medullaris to ascend within the spinal canal. When the cord is tethered by a rigid fibrous filum terminale the cord is stretched and this causes functional neurological impairment.
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