Aims-To compare the levels of conus medullaris in preterm and term neonates; to show the time of ascent to normal; and to evaluate the babies with low conus medullaris levels for tethered cord syndrome. Methods-Levels were assessed using ultrasonography in 41 preterm and 64 term neonates. Results-In the preterm group the conus medullaris level in one infant (2.4%) was below L4. In three infants (7.2%) it was between L2 and L3 and in 37 infants (90.4%) it was above L2. In the term group it was below L4 in one baby (1.6%), between L2 and L3 in four (6.3%), and above L2 in 57 babies (92.1%). The diVerence in the conus medullaris levels between term and preterm neonates and genders was not significant. Two patients, one with a conus medullaris level at L4-L5, and the other at L2-L3, had Down's syndrome. Conclusion-The ascent of conus medullaris seems to occur early in life. It is important to follow up patients with conus medullaris levels at or below the 4th lumbar vertebra for the development of tethered cord syndrome. The medulla spinalis, which has the same length as the vertebral canal in the early fetal life, moves cranially. The precise timing of this ascent is unknown.1 It is important to know the level of conus medullaris in both preterm and term babies to perform lumbar puncture and surgical procedures. The infants in whom lower levels of conus medullaris or thick filum terminale are determined, must be followed up for tethered cord syndrome, so that early surgical intervention can be undertaken.Ultrasonography is safe and non-invasive and can be used to determine the level of conus medullaris, especially in infants younger than 3 months. 2 MethodsIn this study 41 preterm babies between 31 and 37 weeks of gestational age and 64 term babies were examined by ultrasonography to determine the levels of conus medullaris. Gestational ages were determined from the last menstrual date or by antenatal ultrasonography. In the preterm babies, corrected gestational ages were used for the evaluation of conus medullaris if ultrasound examination could not be done immediately because of the clinical instability of the babies.Ultrasound examination was performed using an SSA 250 A machine (Toshiba, Tokyo) with a 7.5 MHz linear transducer. Infants were examined in the prone, gently flexed position. Both longitudinal and transverse sections were performed and 5th lumbar vertebra (L5) was identified by finding the lumbosacral junction and angulation at this point. The conus was marked at the end of tapering distal spinal cord which is hypoechoic and its level determined by the adjacent intervertebral disk space.The 2 test was used for statistical analysis. ResultsSpinal ultrasonography was performed on a total of 106 patients (48 girls and 58 boys). In a patient with cleft lip and cleft palate and congenital hydrocephalus, conus medullaris was found below the 4th lumbar vertebra (L4), but this patient was not included in this study because of his neural defect. Of the other 105 patients, the gestational ages of 41 ba...

Although the clinical features of congenital muscular torticollis are well known, the cause of this disorder still remains hypothetical. The role of heredity is not well established, because there have been only a few studies on it. We presented a family in which five members suffer from CMT in three generations, two of whom were operated on. According to the pattern in the pedigree, probably an autosomal dominant condition could be considered.

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