Lipomatosis of the filum terminale

Case contributed by A.Prof Frank Gaillard

Patient Data

Age: Adult

Non contrast CT of the lumbar spine demonstrates a strip of fat density located within the dura and extending from the superior aspect of L2 to L3/4. Degenerative disc change at L3/4 is present with marked disc height loss and end plate sclerosis. 

On these images the location of the conus cannot be identified, but can be assumed to be at or above the level of L1/2.

MRI

MRI lumbar spine

MRI confirms the presence of fatty tissue (high T1, high T2, suppresses on fat saturated sequences) extending from the conus to at least L5. The conus is located at L1/2 and is normal in appearance. 

Degenerative change is noted once more. 

Case Discussion

This case is typical of incidentally identified lipomatosis of the filum terminale in a patient symptomatic from degenerative change. The absence of a low lying conus and relatively thin filum (<2mm at the level of L5/S1) further suggests that this is an incidental asymptomatic finding. 

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Case information

rID: 8899
Case created: 8th Mar 2010
Last edited: 24th Nov 2015
Inclusion in quiz mode: Included

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