Lipomyelocele and tethered cord
Bowel and bladder symptoms
MRI lumbar spine
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MRI of the lumbar spine demonstrates a low lying conus (terminating at L4) associated with spina bifida of L5 and S1. In the defect is a fatty mass attached to the dorsal aspect of the cord. The filum terminale appears separate to the mass, and can be traced as it descends in the thecal sac anterior to the fatty mass.
Importantly the lipoma-neural placode interface is seen within the spinal canal, in keeping with lipomyelocele (rather than lipomyelomeningocele).
Lipomyelocele is one of the types of lipomatous masses of the central nervous system (along with lipomyelomeningocele, intradural lipomas and fatty filum terminale).