Tethered cord syndrome

Case contributed by Dr Nick Tarasov

Presentation

Lower spastic paraparesis, bladder dysfunction

Patient Data

Age: 15 years
Gender: Male
MRI

Conus medullaris is shifted down to the level of the L5 vertebra conjoined with dura mater by the filum terminale lipoma at the L4-S1 level with narrowing of the posterior subarachnoid space and dural sac widening.

Rugger-jersey sign obviously seen on T1 sequence. Biconcave vertebral deformation. Incidental hemangioma in the body of the L3 vertebra.

Bilateral hydronephrosis, right kidney atrophy.

Case Discussion

Tethered cord associated with the filum terminale lipoma probably causing bladder dysfunction and vesicoureteral reflux leading to the hydronephrosis and the right kidney scarring that in turn led to the secondary hyperparathyroidism of chronic renal failure (prominent subendplate osteosclerosis and vertebral body osteoporosis).

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Case information

rID: 59142
Published: 23rd Mar 2018
Last edited: 25th Mar 2018
Inclusion in quiz mode: Included
Institution: USMU

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