Tethered cord

Case contributed by Dr Abdallah Khateeb

Presentation

Newly developing bladder dysfunction. History of previous lumbar region surgery.

Patient Data

Age: 5 years
Gender: Female
MRI

Lumbar spine MRI

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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Case information

rID: 44992
Case created: 11th May 2016
Last edited: 16th May 2016
Inclusion in quiz mode: Included

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