Presentation
Lower spastic paraparesis, bladder dysfunction
Patient Data
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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