Tethered spinal cord
Urinary incontinence, lower back pain and intermittent weakness of lower extremities. Sent for the cranial and lumbosacral spine MRI.
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Conus medullaris extends well bellow level of L2 and projecting all the way to the S3 level, where it seems to be attached to a soft tissue heterogeneous mass, dominantly hyperintense on T1, iso to hypointense on T2 and STIR. Sacral nerve roots look filiform. Spina bifida in the level of S3.
During their childhood, this patient underwent some kind of surgery in lumbosacral region (probably myelocoele), but he didn't present any documents about that intervention.
Now he has urinary incontinence, intermittent weakness of lower extremities and lower back pain, so he underwent MRI of endocranium which was unremarkable, as well as LS spine MRI which shows spinal cord extending to the level of S3, were attached to a heterogeneous mass, which probably presents with a mixture of fat and scar tissue.