Medullary cone movement in subjects with a normal spinal cord and in patients with a tethered spinal cord

T D Witkamp, W P Vandertop, F J Beek, N C Notermans, R H Gooskens, P F van Waes

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

PURPOSE: To compare movement of the normal medullary cone when the patient has changed from a supine to prone position with that in patients with known or suspected tethered spinal cord syndrome.

MATERIALS AND METHODS: Fifty-six individuals divided into three groups were examined with lumbar spine magnetic resonance (MR) imaging performed with the patient in the prone and supine positions. Group 1 consisted of 15 healthy volunteers and six patients with a herniated disk; group 2, 25 patients clinically suspected of having a tethered cord; and group 3, 10 patients who previously had undergone tethered cord surgery.

RESULTS: All group 1 subjects showed distinct and statistically significant medullary cone movement (range, 21%--41%); no patient in group 3 showed movement (Wilcoxon rank sum test, P <.001). In group 2, the 20 patients in whom a definite diagnosis of tethered cord syndrome was made on the basis of initial supine MR image findings showed no movement, whereas two of five patients with normal supine MR images had abnormal and decreased cone movement at prone imaging.

CONCLUSION: Prone MR imaging has no additional value when the supine MR image has clearly shown the cause of tethering or in patients who have undergone tethered cord surgery, but it can provide additional information in patients clinically suspected of having a tethered cord and in whom supine MR imaging depicted no abnormalities.

Original languageEnglish
Pages (from-to)208-12
Number of pages5
JournalRadiology
Volume220
Issue number1
DOIs
Publication statusPublished - Jul 2001

Cite this

Witkamp, T D ; Vandertop, W P ; Beek, F J ; Notermans, N C ; Gooskens, R H ; van Waes, P F. / Medullary cone movement in subjects with a normal spinal cord and in patients with a tethered spinal cord. In: Radiology. 2001 ; Vol. 220, No. 1. pp. 208-12.
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title = "Medullary cone movement in subjects with a normal spinal cord and in patients with a tethered spinal cord",
abstract = "PURPOSE: To compare movement of the normal medullary cone when the patient has changed from a supine to prone position with that in patients with known or suspected tethered spinal cord syndrome.MATERIALS AND METHODS: Fifty-six individuals divided into three groups were examined with lumbar spine magnetic resonance (MR) imaging performed with the patient in the prone and supine positions. Group 1 consisted of 15 healthy volunteers and six patients with a herniated disk; group 2, 25 patients clinically suspected of having a tethered cord; and group 3, 10 patients who previously had undergone tethered cord surgery.RESULTS: All group 1 subjects showed distinct and statistically significant medullary cone movement (range, 21{\%}--41{\%}); no patient in group 3 showed movement (Wilcoxon rank sum test, P <.001). In group 2, the 20 patients in whom a definite diagnosis of tethered cord syndrome was made on the basis of initial supine MR image findings showed no movement, whereas two of five patients with normal supine MR images had abnormal and decreased cone movement at prone imaging.CONCLUSION: Prone MR imaging has no additional value when the supine MR image has clearly shown the cause of tethering or in patients who have undergone tethered cord surgery, but it can provide additional information in patients clinically suspected of having a tethered cord and in whom supine MR imaging depicted no abnormalities.",
keywords = "Adolescent, Adult, Child, Child, Preschool, Female, Humans, Lumbar Vertebrae/anatomy & histology, Magnetic Resonance Imaging/methods, Male, Middle Aged, Movement/physiology, Neural Tube Defects/complications, Prone Position/physiology, Reference Values, Sensitivity and Specificity, Spinal Cord/physiopathology, Spinal Cord Compression/diagnosis, Supine Position/physiology",
author = "Witkamp, {T D} and Vandertop, {W P} and Beek, {F J} and Notermans, {N C} and Gooskens, {R H} and {van Waes}, {P F}",
year = "2001",
month = "7",
doi = "10.1148/radiology.220.1.r01jl06208",
language = "English",
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Medullary cone movement in subjects with a normal spinal cord and in patients with a tethered spinal cord. / Witkamp, T D; Vandertop, W P; Beek, F J; Notermans, N C; Gooskens, R H; van Waes, P F.

In: Radiology, Vol. 220, No. 1, 07.2001, p. 208-12.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Medullary cone movement in subjects with a normal spinal cord and in patients with a tethered spinal cord

AU - Witkamp, T D

AU - Vandertop, W P

AU - Beek, F J

AU - Notermans, N C

AU - Gooskens, R H

AU - van Waes, P F

PY - 2001/7

Y1 - 2001/7

N2 - PURPOSE: To compare movement of the normal medullary cone when the patient has changed from a supine to prone position with that in patients with known or suspected tethered spinal cord syndrome.MATERIALS AND METHODS: Fifty-six individuals divided into three groups were examined with lumbar spine magnetic resonance (MR) imaging performed with the patient in the prone and supine positions. Group 1 consisted of 15 healthy volunteers and six patients with a herniated disk; group 2, 25 patients clinically suspected of having a tethered cord; and group 3, 10 patients who previously had undergone tethered cord surgery.RESULTS: All group 1 subjects showed distinct and statistically significant medullary cone movement (range, 21%--41%); no patient in group 3 showed movement (Wilcoxon rank sum test, P <.001). In group 2, the 20 patients in whom a definite diagnosis of tethered cord syndrome was made on the basis of initial supine MR image findings showed no movement, whereas two of five patients with normal supine MR images had abnormal and decreased cone movement at prone imaging.CONCLUSION: Prone MR imaging has no additional value when the supine MR image has clearly shown the cause of tethering or in patients who have undergone tethered cord surgery, but it can provide additional information in patients clinically suspected of having a tethered cord and in whom supine MR imaging depicted no abnormalities.

AB - PURPOSE: To compare movement of the normal medullary cone when the patient has changed from a supine to prone position with that in patients with known or suspected tethered spinal cord syndrome.MATERIALS AND METHODS: Fifty-six individuals divided into three groups were examined with lumbar spine magnetic resonance (MR) imaging performed with the patient in the prone and supine positions. Group 1 consisted of 15 healthy volunteers and six patients with a herniated disk; group 2, 25 patients clinically suspected of having a tethered cord; and group 3, 10 patients who previously had undergone tethered cord surgery.RESULTS: All group 1 subjects showed distinct and statistically significant medullary cone movement (range, 21%--41%); no patient in group 3 showed movement (Wilcoxon rank sum test, P <.001). In group 2, the 20 patients in whom a definite diagnosis of tethered cord syndrome was made on the basis of initial supine MR image findings showed no movement, whereas two of five patients with normal supine MR images had abnormal and decreased cone movement at prone imaging.CONCLUSION: Prone MR imaging has no additional value when the supine MR image has clearly shown the cause of tethering or in patients who have undergone tethered cord surgery, but it can provide additional information in patients clinically suspected of having a tethered cord and in whom supine MR imaging depicted no abnormalities.

KW - Adolescent

KW - Adult

KW - Child

KW - Child, Preschool

KW - Female

KW - Humans

KW - Lumbar Vertebrae/anatomy & histology

KW - Magnetic Resonance Imaging/methods

KW - Male

KW - Middle Aged

KW - Movement/physiology

KW - Neural Tube Defects/complications

KW - Prone Position/physiology

KW - Reference Values

KW - Sensitivity and Specificity

KW - Spinal Cord/physiopathology

KW - Spinal Cord Compression/diagnosis

KW - Supine Position/physiology

U2 - 10.1148/radiology.220.1.r01jl06208

DO - 10.1148/radiology.220.1.r01jl06208

M3 - Article

VL - 220

SP - 208

EP - 212

JO - Radiology Now

JF - Radiology Now

SN - 0033-8419

IS - 1

ER -