Case 8: 5-month-old paraplegic boy with SSD

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Presentation transcript:

Case 8: 5-month-old paraplegic boy with SSD Case 8: 5-month-old paraplegic boy with SSD. The lower limbs are deformed, there are equinocavovarus feet, and kyphoscoliosis is present with a bony spur along the back (arrow), corresponding to the site of SSD.fig 2. Case 9: 1-month-old girl with SSD and a... Case 8: 5-month-old paraplegic boy with SSD. The lower limbs are deformed, there are equinocavovarus feet, and kyphoscoliosis is present with a bony spur along the back (arrow), corresponding to the site of SSD.fig 2. Case 9: 1-month-old girl with SSD and associated partial sacrococcygeal agenesis.A, Lateral radiograph at age 12 months shows marked offset between the two spinal segments above and below the dysgenesis, resulting in marked kyphosis. Only nine thoracic vertebrae and the corresponding pair of ribs are visible; there is complete disconnection of the spine at the level of the dysgenesis, and the lower segment shows a hypoplastic L3 (open arrow) and deformed L4 (solid arrow). Partial sacrococcygeal agenesis is also present, with only S1 through S4 visible.B–E, Sagittal spin-echo (SE) T1-weighted MR images (620/30/4 [TR/TE/excitations]) at age 39 days (B and C) and sagittal fast SE T2-weighted (4000/112/2) (D) and axial fast SE T2-weighted (5000/96/2) (E) MR images at age 24 months confirm the complete disconnection of the spinal segments above and below the dysgenesis. A horseshoe kidney is seen in B and C (asterisk). The upper cord ends at the midthoracic level with a wedge-shaped termination (open arrow, B); a questionable threadlike structure extends below (solid arrow, B). No cord is discernible at the level of the anomaly. Below, the bulky, low-lying lower cord (arrows, C and D) appears to connect with the bottom of a dermal sinus (white arrowhead, B–D). Nerve roots with an aberrant course anteriorly to the lower cord are seen on T2-weighted images (black arrowhead, D). Note worsening of the degree of kyphosis at age 24 months (compare C and D), causing the dermal sinus to collapse. In the axial plane, the bulky lower cord (star, E) and nerve roots are visible coursing anterior to the cord (black arrowheads, E). Posteriorly, the CSF-filled lower spinal canal (asterisk, E) connects with the dermal sinus (arrow, E). Paolo Tortori-Donati et al. AJNR Am J Neuroradiol 1999;20:445-456 ©1999 by American Society of Neuroradiology