J Korean Radiol Soc.  1994 Sep;31(3):545-551.

Clinical and MR Findings of Tethered Cord Syndrome

• Kim HY
• Lee YS
• Lim HK
• Chung EC
• Chung HI
• Suh JS
• Lee SR

Abstract

PURPOSE
Tethered cord syndrome(TCS) is defined as low position of the conus medullaris by the abnormally fixed spinal cord with progressive neurologic deficit
MATERIALS AND METHODS
To evaluate the findings of TCS at MRI and its diagnostic value, we performed a retrospective analysis of MRI of 30 patients with emphasis on clinical manifestation, level of conus medullaris, cause of tethering, and associated findings.
RESULTS
Clinical presentation included back mass(26 cases), neurogenic bladder(5 cases), urinary incontinence(5 cases), progressive constipation(2 cases), skin dimpling(1 case), gait disturbance(1 case) and club foot (1 case). Neurologic deficit was developed in 11 cases(40% and mean age of these patients at the time of diagnosis was 8.6 years. The most common cause of tethering was lipoma(63%). The tips of conus medullaris were below the level of the second lumbar spine in all patients. The causes of tethering were lipomatous component(spinal lipoma and lipomyelomenigocele) in 67% myelomeningocele in 20%, presacral mass in 7%, thickened filum terminale in 3% and postoperative change in 3%. Associated anomalies included syringomyelia(20%) and hydrocephalus was associated in 3 out of 5 patients who underwent brain MRI.
CONCLUSION
MRI clearly delineated the location of conus, tethering of the filum terminale with their causes and associated abnormalities. MRI examination is a very useful diagnostic tool for the early evaluation of TCS and the postoperative follow up.

MeSH Terms

Brain
Cauda Equina
Conus Snail
Diagnosis
Follow-Up Studies
Foot
Gait
Humans
Hydrocephalus
Lipoma
Magnetic Resonance Imaging
Meningomyelocele
Neural Tube Defects*
Neurologic Manifestations
Retrospective Studies
Skin
Spinal Cord
Spine