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Neurology (Expert Forum)
30mo old girrl with multiple spinal probles possible tcs
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30mo old girrl with multiple spinal probles possible tcs
by joanna hanna, Aug 14, 2000 12:00AM
we have a 30 mo baby girl who has conginital scoliosis28 degree curve, partial sacreal agenesis, and stable mild kyposis.
recentally we had a MRI of lumbar spin in hte result it showed her to have a large central conal, it also showd conginital scoliosis and a lipoma that involved both the conus nedullaris and filum terminale it also involves both the infra and extradurmal components and extends down to the l5 s1 levels.they wher unable to identify where the conus ended. she also has 2 hemivertabre at l2,l3.
given impression was conginital scoliosis and a filum terminale lipoma with other findings to raise suspsion of tight filum terminale syndrome.
is tight filum terminale same as tethered cord, and a child with a lipoma should it be left alone? also exactually what part of the cord is involved with the lipoma. does this sound like a tethored cord and if it does is it probable to expect surgery to prevent any or further deteriation in gate or bowela nd bladder function or is it a wait and se situation? do you know of any good nuerosurgones in OU school of MED that practice at childrens hosp of oklahoma.
any info would be of great value at this point in time. thank you very much
recentally we had a MRI of lumbar spin in hte result it showed her to have a large central conal, it also showd conginital scoliosis and a lipoma that involved both the conus nedullaris and filum terminale it also involves both the infra and extradurmal components and extends down to the l5 s1 levels.they wher unable to identify where the conus ended. she also has 2 hemivertabre at l2,l3.
given impression was conginital scoliosis and a filum terminale lipoma with other findings to raise suspsion of tight filum terminale syndrome.
is tight filum terminale same as tethered cord, and a child with a lipoma should it be left alone? also exactually what part of the cord is involved with the lipoma. does this sound like a tethored cord and if it does is it probable to expect surgery to prevent any or further deteriation in gate or bowela nd bladder function or is it a wait and se situation? do you know of any good nuerosurgones in OU school of MED that practice at childrens hosp of oklahoma.
any info would be of great value at this point in time. thank you very much
Doctor's Answer
by CCF Neuro[P] MD, RPS, Aug 14, 2000 12:00AM
Dear Joanna:
Sorry to hear about your daughter. The problems with spinal cord development most, if not all have an abnormal conus and filum terminale. The lipoma is likely part of the syndrome, because it is also due to abnormal spinal cord development. The abnormal filum is the same as a tethered cord as the cord becomes "tethered" due to the abnormal growth of the spinal cord. Whether surgery is needed is in part what the symptoms of your daughter and the MRI shows to be the extent of the lesion. Most surgeons like to wait for the child to grow alittle before surgery, but it is individual. I am sorry but I do not know anyone at OU. I would imagine that they are very good, but always seek a second opinion about types of surgery. It will give a feel about another opinion and what to expect. I hope things work out well with your daughter.
Sincerely,
CCF Neuro MD
Sorry to hear about your daughter. The problems with spinal cord development most, if not all have an abnormal conus and filum terminale. The lipoma is likely part of the syndrome, because it is also due to abnormal spinal cord development. The abnormal filum is the same as a tethered cord as the cord becomes "tethered" due to the abnormal growth of the spinal cord. Whether surgery is needed is in part what the symptoms of your daughter and the MRI shows to be the extent of the lesion. Most surgeons like to wait for the child to grow alittle before surgery, but it is individual. I am sorry but I do not know anyone at OU. I would imagine that they are very good, but always seek a second opinion about types of surgery. It will give a feel about another opinion and what to expect. I hope things work out well with your daughter.
Sincerely,
CCF Neuro MD
joanna