Presentation
Newly developing bladder dysfunction. History of previous lumbar region surgery.
Patient Data
The spinal cord ends at an abnormally low level, looking as if it is being pulled by a distorted and enhancing subcutaneous tissue, mostly granulation tissue and fibrotic changes due to the previous surgery.
A fusiform CSF-intensity lesion within the distal spinal cord.
Dural ectasia opposite to the surgery site.
Better seen on the axial sections, the spinal cord ends as two separate parts, however, no bone spur or septum is seen in between them.
Case Discussion
The constellation of the patient's findings are mostly the result of recurrent tethered cord and diastematomyelia, along with hydromyelia which is a known associated finding with diastematomyelia.
This patient underwent surgical release of a tethered cord, which was successful. The current presentation and imaging findings are best explained by fibrosis and recurrent cord tethering.
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