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For children younger than eight weeks of age (and possibly in utero), a tethered cord may be observed using ultrasonography. Ultrasonography may still be useful through age 5 in limited circumstances. [15] MRI imaging appears to be the gold standard for diagnosing a tethered cord. [16] [17] A tethered cord is often diagnosed as a "low conus".
In adults, surgery to free (detether) the spinal cord can reduce the size and further development of cysts in the cord and may restore some function or alleviate other symptoms. Tethered Cord Syndrome is causally linked to Chiari Malformation and any affirmative diagnosis of TCS must be followed by screening for Chiari's several degrees.
Lumbosacral adult diastematomyelia is even rarer. Bony malformations and dysplasias are generally recognized on plain x-rays. MRI scanning is often the first choice of screening and diagnosis. MRI generally give adequate analysis of the spinal cord deformities although it has some limitations in giving detailed bone anatomy.
Finally, the use of magnetic resonance imaging (MRI) allowed for even better depiction of the spine and soft tissue abnormalities in particular. Again, a novel acronym was proposed to classify patients without traumatic signs using radiographs, CT and MRI. The term spinal cord injury without neuroimaging abnormality (SCIWONA) was used.
The spinal cord lesion or the scarring due to surgery may result in a tethered spinal cord. In some individuals, this causes significant traction and stress on the spinal cord and can lead to a worsening of associated paralysis, scoliosis , back pain, and worsening bowel and/or bladder function.
In a split cord malformation, some portion of the spinal cord is divided into parallel halves. The thecal sac may be divided and surround each half with a spike of cartilage or bone dividing the halves (Type I), or both halves may be present within the same sac where the dura is bound to a band of fibrous tissue (Type II).
Nowadays, MRI has all but replaced myelography. [4] MRI is preferable because injection of contrast medium into the spinal canal is infrequently needed for better images. However, a CT myelogram may be useful for patients who cannot undergo MRI (e.g., those with pacemakers or cochlear implants). CT is preferred when MRI images are limited by ...
Functional magnetic resonance imaging (fMRI) of the spinal cord (spinal fMRI) is an adaptation of the fMRI method that has been developed for use in the brain. Although the basic principles underlying the methods are the same, spinal fMRI requires a number of specific adaptations to accommodate the periodic motion of the spinal cord, the small cross-sectional dimensions (roughly 8 mm × 15 mm ...