Presentation
Lower back pain.
Patient Data
The spinal cord terminates below L5. The filum terminale is thickened. No evidence of meningocele or lipomeningocele.
CT demonstrating unfused posterior elements (spina bifida).
Case Discussion
Tethered cord and spina bifida are types of spinal dysraphism. Tethered cord manifests with a low-lying conus medullaris (bellow L2) and a thickened filum terminale (>2mm).
Tethered cord can be primary (congenital) or acquired (arachnoid adhesions due to infection, trauma, scar tissue, or spinal tumor), it can be diagnosed in adulthood.
In tethered cord, the spinal cord is fixed and its movement is limited.
Surgical release is done for patients with neurological symptoms.