Definition
Conus medullaris below L2 / tethered
- unable to move freely with movement / growth
Aetiology
Thickened filum terminale (> 2mm at L5/S1)
Intradural lipoma
Diastomatomyelia
Surgery to close myelomeningocoele
- almost all will have signs of tethered cord at site of surgery
Issue
Stretches and damages the cord as child grows
- neurology
- pain
- difficulty walking
- foot deformity
Rapid progression of scoliosis
Clinical
80 - 90% of children will have cutaneous manifestation
MRI
Management
Open surgical release
Indication
- child
- neurological symptoms
- progressive scoliosis