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Tethered Cord
Roya Sohaey, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Abbreviations

              • Tethered spinal cord (TSC)
            • Definitions

              • Low-lying conus medullaris (CM)
                • Short, thick filum terminale in classic isolated cases
                • Often seen with associated back anomaly
              • Excessive tension on spinal cord

            IMAGING

            • General Features

              • Imaging Recommendations

                • Ultrasonographic Findings

                  • MR Findings

                    DIFFERENTIAL DIAGNOSIS

                      PATHOLOGY

                      • General Features

                        • Gross Pathologic & Surgical Features

                          CLINICAL ISSUES

                          • Presentation

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  • Image Interpretation Pearls

                                    Selected References

                                    1. Blondiaux E et al: Prenatal US evaluation of the spinal cord using high-frequency linear transducers. Pediatr Radiol. 41(3):374-83, 2011
                                    2. Duczkowska A et al: Magnetic resonance imaging in the evaluation of the fetal spinal canal contents. Brain Dev. 33(1):10-20, 2010
                                    3. Hertzler DA 2nd et al: Tethered cord syndrome: a review of the literature from embryology to adult presentation. Neurosurg Focus. 29(1):E1, 2010
                                    4. O'Neill BR et al: Prevalence of tethered spinal cord in infants with VACTERL. J Neurosurg Pediatr. 6(2):177-82, 2010
                                    5. Sohaey R et al: Prenatal diagnosis of tethered spinal cord. Ultrasound Q. 25(2):83-7; quiz 93-5, 2009
                                    6. Lew SM et al: Tethered cord syndrome: an updated review. Pediatr Neurosurg. 43(3):236-48, 2007
                                    7. Lowe LH et al: Sonography of the neonatal spine: part 1, Normal anatomy, imaging pitfalls, and variations that may simulate disorders. AJR Am J Roentgenol. 188(3):733-8, 2007
                                    8. Lowe LH et al: Sonography of the neonatal spine: part 2, Spinal disorders. AJR Am J Roentgenol. 188(3):739-44, 2007
                                    9. Zalel Y et al: Development of the fetal spinal cord: time of ascendance of the normal conus medullaris as detected by sonography. J Ultrasound Med. 25(11):1397-401; quiz 1402-3, 2006
                                    10. Rinaldi F et al: Tethered cord syndrome. J Neurosurg Sci. 49(4):131-5; discussion 135, 2005
                                    11. Haro H et al: Long-term outcomes of surgical treatment for tethered cord syndrome. J Spinal Disord Tech. 17(1):16-20, 2004
                                    12. Lam WW et al: Ultrasound measurement of lumbosacral spine in children. Pediatr Neurol. 30(2):115-21, 2004
                                    13. Michelson DJ et al: Tethered cord syndrome in childhood: diagnostic features and relationship to congenital anomalies. Neurol Res. 26(7):745-53, 2004
                                    14. Tubbs RS et al: Can the conus medullaris in normal position be tethered? Neurol Res. 26(7):727-31, 2004
                                    15. McLone DG et al: The tethered spinal cord: diagnosis, significance, and management. Semin Pediatr Neurol. 4(3):192-208, 1997
                                    16. Roszkowski M et al: [The tethered spinal cord: diagnosis and surgical considerations.] Pediatr Pol. 71(2):135-41, 1996
                                    Related Anatomy
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                                    Related Differential Diagnoses
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                                    References
                                    Tables

                                    Tables

                                    KEY FACTS

                                    • Terminology

                                      • Imaging

                                        • Top Differential Diagnoses

                                          • Pathology

                                            • Clinical Issues

                                              TERMINOLOGY

                                              • Abbreviations

                                                • Tethered spinal cord (TSC)
                                              • Definitions

                                                • Low-lying conus medullaris (CM)
                                                  • Short, thick filum terminale in classic isolated cases
                                                  • Often seen with associated back anomaly
                                                • Excessive tension on spinal cord

                                              IMAGING

                                              • General Features

                                                • Imaging Recommendations

                                                  • Ultrasonographic Findings

                                                    • MR Findings

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          • Gross Pathologic & Surgical Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Natural History & Prognosis

                                                                • Treatment

                                                                  DIAGNOSTIC CHECKLIST

                                                                  • Consider

                                                                    • Image Interpretation Pearls

                                                                      Selected References

                                                                      1. Blondiaux E et al: Prenatal US evaluation of the spinal cord using high-frequency linear transducers. Pediatr Radiol. 41(3):374-83, 2011
                                                                      2. Duczkowska A et al: Magnetic resonance imaging in the evaluation of the fetal spinal canal contents. Brain Dev. 33(1):10-20, 2010
                                                                      3. Hertzler DA 2nd et al: Tethered cord syndrome: a review of the literature from embryology to adult presentation. Neurosurg Focus. 29(1):E1, 2010
                                                                      4. O'Neill BR et al: Prevalence of tethered spinal cord in infants with VACTERL. J Neurosurg Pediatr. 6(2):177-82, 2010
                                                                      5. Sohaey R et al: Prenatal diagnosis of tethered spinal cord. Ultrasound Q. 25(2):83-7; quiz 93-5, 2009
                                                                      6. Lew SM et al: Tethered cord syndrome: an updated review. Pediatr Neurosurg. 43(3):236-48, 2007
                                                                      7. Lowe LH et al: Sonography of the neonatal spine: part 1, Normal anatomy, imaging pitfalls, and variations that may simulate disorders. AJR Am J Roentgenol. 188(3):733-8, 2007
                                                                      8. Lowe LH et al: Sonography of the neonatal spine: part 2, Spinal disorders. AJR Am J Roentgenol. 188(3):739-44, 2007
                                                                      9. Zalel Y et al: Development of the fetal spinal cord: time of ascendance of the normal conus medullaris as detected by sonography. J Ultrasound Med. 25(11):1397-401; quiz 1402-3, 2006
                                                                      10. Rinaldi F et al: Tethered cord syndrome. J Neurosurg Sci. 49(4):131-5; discussion 135, 2005
                                                                      11. Haro H et al: Long-term outcomes of surgical treatment for tethered cord syndrome. J Spinal Disord Tech. 17(1):16-20, 2004
                                                                      12. Lam WW et al: Ultrasound measurement of lumbosacral spine in children. Pediatr Neurol. 30(2):115-21, 2004
                                                                      13. Michelson DJ et al: Tethered cord syndrome in childhood: diagnostic features and relationship to congenital anomalies. Neurol Res. 26(7):745-53, 2004
                                                                      14. Tubbs RS et al: Can the conus medullaris in normal position be tethered? Neurol Res. 26(7):727-31, 2004
                                                                      15. McLone DG et al: The tethered spinal cord: diagnosis, significance, and management. Semin Pediatr Neurol. 4(3):192-208, 1997
                                                                      16. Roszkowski M et al: [The tethered spinal cord: diagnosis and surgical considerations.] Pediatr Pol. 71(2):135-41, 1996