OC74: Prenatal ultrasound diagnosis of tethered cord in fetuses without open neural tube defects

Abstract

Tethered cord is most commonly associated with open neural tube defects but is also seen in isolation or in association with other spinal anomalies. The level of the conus can be identified with ultrasound but is not routinely imaged. We report five cases of tethered cord in fetuses without open neural tube defects. Fetuses with tethered cord were examined by ultrasound. Two cases had myelocystocele (skin covered myelocele), one fetus had VACTERL association, and one fetus had a clubfoot and lower back fatty tail (skin lipoma). The low conus was seen with ultrasound in these five cases. Three-dimensional ultrasound was helpful in identifying lumbar and sacral spine levels. Three-dimensional ultrasound of the lipomatous ‘tail’ was also performed. Postnatal MRI confirmed the diagnosis in all five cases. All cases were repaired surgically. Tethered cord is associated with childhood morbidity and its prenatal diagnosis is rarely reported in fetuses without open spina bifida. With these five cases, we show that this diagnosis can be made with accuracy and visualization of the conus should be performed in fetuses with other spinal abnormalities or clubfoot.