Sonographic evaluation of the fetal conus medullaris at 20 to 24 weeks' gestation

Perlitz, Yuri; Izhaki, Ido; Ben‐Ami, Moshe

doi:10.1002/pd.2572

Cited by 39 publications

(38 citation statements)

References 8 publications

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“…A distinguishable rise of the CM in relation to the vertebral column during fetal life was detected. In the third series, Perlitz et al [14] evaluated 110 fetuses from 20 to 24 gestational weeks with a normal postnatal follow-up. The CM level was demonstrated in approximately 70% of the fetuses.…”

Section: Discussionmentioning

confidence: 99%

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Prenatal Evaluation of the Fetal Conus Medullaris on a Routine Scan

et al. 2015

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Objective: To assess the ability to identify the conus medullaris (CM) and measure the conus-sacrum distance (CS distance) on a routine scan and the relationship with maternal and fetal factors. Methods: This was a prospective study. The assessment of the CM and the CS distance and the influence of the body mass index (BMI), gestational age (GA) and fetal position were analyzed. The correlation between the femur length (FL) and the GA with the CS distance was evaluated. Results: A total of 696 fetuses were analyzed. The CM could be visualized in 82.3% of the cases, and the CS distance could be analyzed in 81.2% of the cases. The CM assessment was statistically associated with BMI and fetal position but not with GA. The CS distance assessment was statistically associated with BMI and GA but not with fetal position. We determined a significant association between the FL/CS distance and between the GA/CS distance. Conclusions: Assessment of the CM is possible on most routine scans. The CS distance could be introduced to routine scans for the assessment of prenatal skin-covered spinal dysraphism. High BMI, advanced GA and breech presentation could be potential factors limiting the feasibility of evaluating the CM.

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Section: Discussionmentioning

confidence: 99%

“…Few studies describe the appropriate methodology to prenatally assess the correct level of the CM [12,13,14,15,16,17]. …”

Section: Introductionmentioning

confidence: 99%

Prenatal Evaluation of the Fetal Conus Medullaris on a Routine Scan

et al. 2015

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“…Between 13 and 18 weeks of gestation, the conus medullaris is located at the level of L4. Then, due to discrepancy between spine and spinal cord growth and subsequent progressive ascent of the conus medullaris, the latter is observed between L2 and L3 at 19-24 weeks [23] . The distance between the conus medullaris and S1 can be evaluated as reported by Mottet et al [7] , allowing easy identification of tethered spinal cord.…”

Section: Discussionmentioning

confidence: 99%

“…Numbering the vertebrae may be challenging in case of partial or complete sacral agenesis. It has been suggested to evaluate the position of the conus medullaris by identifying the lowest fetal rib (T12) [23] or to measure the distance between the co-nus medullaris and the top of the first sacral vertebra. In our case of spondylocostal dysplasia, even though it is frequently reported, no spinal cord malformation was observed [24] .…”

Section: Discussionmentioning

confidence: 99%

Prenatal Sacral Anomalies Leading to the Detection of Associated Spinal Cord Malformations

Morel

Friszer²,

Jouannic³

et al. 2017

Fetal Diagn Ther

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Introduction: Systematic analysis of the spine is recommended as part of the basic sonographic examination. The aim of our study is to assess the proportion of spinal cord anomalies diagnosed following detection of a sacral anomaly. Material and Methods: We analyzed retrospectively collected data in a prenatal tertiary center during a 9-year period. Patients were referred for second-line ultrasound in the context of diabetes mellitus or following detection of pelvic or lower spine anomalies. We included all cases of sacral anomalies with available postnatal or postmortem outcomes (imaging and/or pathologic data) and excluded all cases of open dysraphism (myelomeningocele). Results: Nineteen patients were included. The mean gestational age was 28 weeks (21-39). Sacral anomalies included 2 cases of complete agenesis, 12 cases of partial agenesis, 4 segmentation anomalies, and 1 case of abnormal angulation of the sacral spine. Fourteen associated spinal cord malformations included 8 tethered spinal cords, 5 truncated spinal cords, and 1 lipoma of the filum terminale. All anomalies were confirmed by postnatal or postmortem examinations. Conclusions: Sacral anomalies detected during basic sonographic examination represent an important warning sign for associated spinal cord anomalies, with possible poor neonatal outcome.

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“…Some studies have evaluated the fetal CM in relation to the last vertebral ossification point [3] or the lumbar vertebrae [4], but the first sacral vertebra (S1) has never been described as a reference. Evaluation of the CM must be associated with a careful examination of the sacrum for an appropriate screening because both entities share a common embryological origin.…”

Section: Introductionmentioning

confidence: 99%

Sonographic Evaluation of Fetal Conus Medullaris and Filum Terminale

et al. 2016

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Background: Sonographic evaluation of the fetal conus medullaris (CM) level is not reproducible. The objectives of this study were to determine the normal position of the fetal CM during pregnancy as well as the normal intradural filum terminale (FT) length and to evaluate their use in detecting tethered cord. Methods: This is a prospective evaluation of normal singleton pregnancies examined by sonography from 17 weeks of gestation to term. Each sonographer had to identify the top of the first sacral vertebra (S1) to measure the distance between it and the conus extremity (CM-S1 distance). The intradural FT distance was measured with 5- to 8-MHz probes. Results: 194 consecutive pregnant women were included. The CM and intradural FT were demonstrated clearly in 164 (84%) cases. The mean CM-S1 distance was 20.6 mm (range 0.5-42). The mean intradural FT distance was 27.9 mm (range 6.6-49.3). Linear regression analysis showed a significant association between both those distances and gestational age (p < 0.05). In cases of tethered cord, the mean CM-S1 distance and the mean intradural FT distance were both below the 5th percentile. Conclusion: Prenatal evaluation of the CM and the intradural FT is feasible and reproducible and seems useful in detecting tethered cord.

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Sonographic evaluation of the fetal conus medullaris at 20 to 24 weeks' gestation

Cited by 39 publications

References 8 publications

Prenatal Evaluation of the Fetal Conus Medullaris on a Routine Scan

Prenatal Evaluation of the Fetal Conus Medullaris on a Routine Scan

Prenatal Sacral Anomalies Leading to the Detection of Associated Spinal Cord Malformations

Sonographic Evaluation of Fetal Conus Medullaris and Filum Terminale

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