[MRI features of adult tethered cord syndrome]

Tethered cord syndrome is a congenital childhood disease, which can also be seen in adults. The aim of this study was to describe magnetic resonance imaging findings of 17 adult patients with tethered cord syndrome and correlate the magnetic resonance images with intraoperative findings.

Between 1994 and 2002, 57 patients with tethered cord syndrome were detected in the neurology and neurosurgery departments in our hospital. Seventeen of these patients were adults and included in this study. The male to female ratio was eleven to six. The mean age was 33.2 years. All patients had physical and neurological examinations and were evaluated with plain films and lumbosacral MRI. All patients underwent surgery and the intraoperative findings were correlated with MRI findings.

MRI could delineate the localization of the conus, thickness of the filum terminale and other pathologic conditions. Thick-short filum terminale, diastematomyelia, intradural lipomas and lipomyelomeningoceles were the most common etiological factors. Conus terminalis terminated distal to the level of L2-L3 intervertebral disc space in all patients. Except two patients with thick-short filum terminale, MRI findings were same with the operative findings. Vertebral anomalies could be detected both with plain films and MRI scans.

MRI is an excellent diagnostic tool in the diagnosis of tethered cord syndrome. Patients with persistent leg and back pain associated with sphincter problems should be evaluated with MRI for a possible tethered cord syndrome.