THE NORMAL CONUS
To determine if the cord is low lying or potentially tethered its important to know what is the lowest level you can see a conus and still call it normal.
The radiology literature varies with a conus at the L2/3 disc or L3 level considered within the normal range.
|NORMAL LOCATION OF CONUS
This is the statement from the International Society of Paediatric Neurosurgeons.
” Any conus medullaris lying caudal to the mid-body of L2 is considered abnormally low (95% confidence limits) and therefore potentially tethered.” (Link to reference below).
NORMAL: Conus at or above mid L2 is normal at any age (orange).
ABNORMAL: Conus below mid-L2 abnormal (green)
|The ISPN Guide to Pediatric Neurosurgery: Ascent of the Conus Medullaris|
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