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Published in: Neuroradiology 4/2023

Open Access 21-01-2023 | Paediatric Neuroradiology

Assessment of the levels of termination of the conus medullaris and thecal sac in the pediatric population

Authors: Mohammed Blaaza, Carolina Filipa Chaves Figueira, Mohamed Rashad Ramali, Cillian McNamara, Mariasavina Severino, Domenico Tortora, Kshitij Mankad, Andrea Rossi

Published in: Neuroradiology | Issue 4/2023

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Abstract

Purpose

This study assessed the position of the termination of the conus medullaris (the point where the spinal cord tapers to an end) and thecal sac (the sheath of dura mater that surrounds the spinal cord and caudal nerve roots) in a large pediatric population, to characterise the nature of the pediatric Gaussian distribution and assess whether age affected the distribution. The study further aimed to assess the effect of gender on termination positions.

Methods

A total of 520 MRI spine studies of children aged between 1 month and 19 years old were collected from two pediatric tertiary referral centres in the UK and Italy. Studies with pathological findings were excluded, and normal scans were found using keyword search algorithms on a database of radiologists’ reports. The reported scans were individually assessed and reviewed by two experienced neuroradiologists. The termination points of the conus medullaris and thecal sac were determined for each study. Local IRB approvals were sought.

Results

The results showcased a Gaussian distribution in both conus medullaris (r=0.8997) and thecal sac termination levels (r=0.9639). No statistically significant results were noted with increasing age for the termination positions of the conus medullaris or thecal sac (p = 0.154, 0.063). No statistical significance was observed with gender variation with either anatomical landmark. A weak positive correlation was observed between the termination levels of the conus medullaris and the thecal sac (r=0.2567)

Conclusion

Termination levels across all pediatric age range followed a Gaussian distribution. Knowledge of normal termination levels has relevant clinical implications, including the assessment of patients with suspected spinal dysraphism.
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Metadata
Title
Assessment of the levels of termination of the conus medullaris and thecal sac in the pediatric population
Authors
Mohammed Blaaza
Carolina Filipa Chaves Figueira
Mohamed Rashad Ramali
Cillian McNamara
Mariasavina Severino
Domenico Tortora
Kshitij Mankad
Andrea Rossi
Publication date
21-01-2023
Publisher
Springer Berlin Heidelberg
Published in
Neuroradiology / Issue 4/2023
Print ISSN: 0028-3940
Electronic ISSN: 1432-1920
DOI
https://doi.org/10.1007/s00234-022-03111-8

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