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low conus medullaris with inferior L2
I have a 15 year old who has had an MRI and it has revealed a low conus medullaris with inferior L2. There is a possibility of a tethered spine? We are awaiting the appt with the nerurosurgeon to discuss this. What are some questions that I should ask this MD concerning this matter? What else could this MRI reading suggest other than a tethered spine? How many different MD opinions should I consult on this for a positive correct diagnosis?
A related discussion, Tethered Spinal cord was started.
Hi...I wanted to invite u to join the chiari forum here on Medhelp as several members do have tethered cord , I myself am one that has it...with TC other conditions can occur...syringomyelia and chiari malformation. U need a chiari specialist.
I hope we see u in the chiari forum : )
"selma"
I hope we see u in the chiari forum : )
"selma"
MEDICAL PROFESSIONAL
Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.
Without the ability to examine your daughter and obtain a history, I can not tell you what the implications of her imaging findings are. However I will try to provide you with some useful information.
The spinal cord is encased in the spinal column, which consits of bones and ligaments. The conus is the very last portion of the spinal cord. Because the spinal cord is shorter than the spinal column, the spinal cord ends at the level of the L2 vertebral body. In some people, as the spinal column grows, if a part of the end part of the nerves called the filum terminale is abnormally thickened for whatever reason the conus becomes tethered (stuck), and traction is placed on the spinal cord and conus. This is often what is meant by tethered cord, though the term is also used for other abnormalities more non-specifically. Sometimes, there are associated spinal cord/column abnormalities such as other neural tube defects or congenital anomalies, and these should be searched for.
A low-lying L2 without tethered cord and without symptoms may be of no consequence; it depends on the clinical picture (your son's symptoms, why the MRI was obtained in the first place).
Symptoms of tethered cord or other lower spinal cord abnormalities include leg weakness, bowel and bladder symptoms, and sensory changes in the legs. Evaluation of bladder function with urodynamic studies is important. If symptoms or other abnormalities are not present, and if physical examination is entirely normal, surgery may not be indicated.
Evaluation by an experienced spine surgeon with exerptise in this type of procedure is essential. Evaluation at a tertiary care academic hospital (such as a university hospital) is recommended.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
Without the ability to examine your daughter and obtain a history, I can not tell you what the implications of her imaging findings are. However I will try to provide you with some useful information.
The spinal cord is encased in the spinal column, which consits of bones and ligaments. The conus is the very last portion of the spinal cord. Because the spinal cord is shorter than the spinal column, the spinal cord ends at the level of the L2 vertebral body. In some people, as the spinal column grows, if a part of the end part of the nerves called the filum terminale is abnormally thickened for whatever reason the conus becomes tethered (stuck), and traction is placed on the spinal cord and conus. This is often what is meant by tethered cord, though the term is also used for other abnormalities more non-specifically. Sometimes, there are associated spinal cord/column abnormalities such as other neural tube defects or congenital anomalies, and these should be searched for.
A low-lying L2 without tethered cord and without symptoms may be of no consequence; it depends on the clinical picture (your son's symptoms, why the MRI was obtained in the first place).
Symptoms of tethered cord or other lower spinal cord abnormalities include leg weakness, bowel and bladder symptoms, and sensory changes in the legs. Evaluation of bladder function with urodynamic studies is important. If symptoms or other abnormalities are not present, and if physical examination is entirely normal, surgery may not be indicated.
Evaluation by an experienced spine surgeon with exerptise in this type of procedure is essential. Evaluation at a tertiary care academic hospital (such as a university hospital) is recommended.
Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.
I too was found to have a lower than normal conus medularis, although at the moment since I do not have the specific symptoms of a tethered cord my neurosurgeon is keeping an eye on things and I see him every six months. Be sure to tell the neurosurgeon all symptoms. Especially if there is any numbness or tingling on the inside of the thigh. Be sure to ask the doctor how low is the conus medularis typically it lies at L1-L2, and if he or she sees anything that could possibly be pulling on the cord to cause the conus medularis to be low. Good luck and I hope that your son gets the correct help he needs.
achilles2
achilles2
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