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Tethered Cord


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Tethered Cord

Elliot K. Fishman, MD
Director of Diagnostic Imaging and Body CT, Professor of Radiology and Radiological Science, Johns Hopkins
Karen M. Horton, MD
Professor and Interim Chair, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins

These images demonstrate low termination of the spinal cord which is thinned and plastered against the dorsal aspect of the thecal sac at the L3-L4 level. There is a tiny cord syrinx distally and mild diffuse T2 hyperintensity of the distal cord compatible with myelomalacia. There is a small focus of intradural fat posteriorly at the terminal aspect of the cord which is best seen on the T1 weighted images.There are very prominent fat filled epidural spaces which narrow the spinal canal. This patient has a history of lipomyelomeningocele which was repaired and presented with increased lower extremity numbness secondary to retethering of the cord. Lipomyelomeningocele is a closed spinal dysraphism where meninges and the neural placode herniate through the dysraphism into the subcutaneous lipoma.