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Clinical History:
Back pain in a 58 year old woman 

Diagnosis:
Tethered cord

MR Technique: 
2D FSE T1- and T2-weighted sagittal 4 mm sections of the lumbar spine are presented, acquired at 1.5 T on a Siemens Avanto MR system. Imaging parameters of TR/TE = 665/7.9 and 3130/98 were employed, with scan times of 3:35 and 3:32 respectively.

Imaging Findings:
The spinal cord extends to the termination of the thecal sac, without noticeable change in caliber (no distinct conus is identified). The cord is tethered in the low sacral region, with a small lipomatous mass also identified in the region of tethering. Post-operative and dysraphic changes are noted in the posterior paraspinal soft tissues at the L5 and sacral levels. Given the patient’s age, these findings could represent either a tethered cord present from birth (with repair of the myelomeningocele only at that time) or retethering (with release of the tether at the time of original surgery).