Male, 9 years old, with urinary incontinence, assess for tethered cord. Five lumbar vertebral bodies are present with mild transitional morphology of L5. Vertebral body height and morphology are normal. No segmentation anomalies are detected. Spinal alignment is anatomic. Marrow signal characteristics are within normal limits. No evidence of marrow replacement or marrow edema is seen.The visualized spinal cord and conus are unremarkable. The conus tip terminates at the L1 level which is normal. The nerve roots of cauda equina disperse evenly through the thecal sac. The filum terminale is not thickened and appears dark on T2 weighted sequences. On some slices (see image 22 and 26, series 601), there is minimal T1 hyperintensity adjacent to the filum which could reflect the sequelae of prior instrumentation, or less likely fatty infiltration. On prone images, the conus and cauda equina demonstrate clear evidence of anterior displacement.The intervertebral disks demonstrate normal morphology and signal characteristics. No evidence of spinal canal or neuroforaminal stenosis is seen.
No definite evidence is seen to suggest persistent tethered cord. In particular, the conus and cauda equina are clearly anteriorly displaced on prone imaging. The filum terminale is not thickened and appears T2 hypointense throughout. On some slices, there is the appearance of mild T1 hyperintensity adjacent to the filum which could represent sequelae of prior instrumentation or, less likely, residual fatty infiltration.