Male, 5 years old, with history severe constipation, L1-L2 vertebral anomaly, solitary kidney. A partial block vertebra anomaly is demonstrated at the L1 level. Specifically, there is partial segmentation of the right aspect of the vertebral body which is taller than the left. There are two pedicles on the right resulting in an extra facet complex and an extra neural foramen on the right but no discrete disc space. The left aspect of the L1 vertebra is of normal height and has formed only one pedicle. As a result of this anomaly, there is a relatively focal dextroscoliotic curvature of the spine centered in the upper lumbar region with some compensatory levoscoliosis of the lower lumbar spine. The sacrum is asymmetric as well with the possibility of some posterior dysraphism at the lowest sacral levels, though this is difficult to assess on MR.Counting the block vertebra at L1 is a single vertebral body level, there is a normal complement of vertebral bodies which otherwise appear to be fully formed and intact. Sagittal alignment is within normal limits. No evidence of marrow replacement or edema is seen. The spinal canal and neural foramina are patent throughout. The intervertebral discs are normal.The conus tip terminates at the upper L3 level which is below the lower limit of normal. The filum terminale is T1 hyperintense for part of its course and closely apposed to the posterior aspect of the thecal sac. The spinal cord otherwise demonstrates normal morphology. On prone images, there does not appear to be much anterior motion of the conus and cauda equina relative to supine imaging.A single right-sided kidney is demonstrated. The partially visualized colon and bladder appear to be distended.
1.Partial block vertebra anomaly at L1 which results in a scoliotic deformity of the lumbar spine. The remaining vertebral body levels appear to be fully formed and normal, with the possible exception of the lowest sacral levels where there may be some posterior dysraphism.2.Findings are seen suggestive of tethered cord including a low-lying conus, fatty infiltration of the filum terminale, and little if any anterior motion on prone imaging.3.Incidental findings include a solitary right kidney and distended bladder and colon.