DOI QR코드

DOI QR Code

Conus Medullaris Levels on Ultrasonography in Term Newborns : Normal Levels and Dermatological Findings

  • Asil, Kiyasettin (Departmant of Radiology, Sakarya University Training and Research Hospital) ;
  • Yaldiz, Mahizer (Departmant of Dermatology, Sakarya University Training and Research Hospital)
  • Received : 2016.12.07
  • Accepted : 2017.03.08
  • Published : 2018.11.01

Abstract

Objective : Ultrasonography (US) is the most non-invasive, safe, and, especially in the period of infancy, best method for visualizing and examining the spinal cord. Furthermore, US is the primary work-up for development of the spinal canal, and for follow-up on issues relating to subcutaneous tissues, bone development, and the spinal cord. Conus medullaris terminates at the second lumbar vertebra, according to a consensus in the literature. Methods : Healthy children under the age of 6 months who were admitted to the radiology clinic for routine USG follow-ups between the dates of March 2012 to December 2014 were included in this study. Results : Our study includes data from 1125 lumbosacral ultrasounds. The terminal point of the conus level of the attended infants, superior, middle part, inferior of the vertebrae L1, L2, and L3. Furthermore, the termination of the discal distance ratio did not differ significantly between genders. Conclusion : Therefore, according to our results, gender is not an influencing factor in the termination of the spinal cord. Based on the study we performed, as well as the previous literature, in infants without a recognized spinal pathology, the spinal cord is detected below the vertebra L3.

Keywords

References

  1. Arthurs OJ, Thayyil S, Wade A, Chong WK, Sebire NJ, Taylor AM; Magnetic Resonance Imaging Autopsy Study Collaborative Group : Normal ascent of the conus medullaris: a post-mortem foetal MRI study. J Matern Fetal Neonatal Med 26 : 697-702, 2013 https://doi.org/10.3109/14767058.2012.746307
  2. Degirmenci S, Guven F, Celayir A, Kilic BD, Say A : Lumbosakral orta hat cilt lezyonlu yenidoganlarda spinal kord anomalileri Orijinal Arastirma. Turk Pediatri Arsivi 38 : 103-106, 2003
  3. Ferahbas A, Utas S, Akcakus M, Gunes T, Mistik S : Prevalence of cutaneous findings in hospitalized neonates: a prospective observational study. Pediatr Dermatol 26 : 139-142, 2009 https://doi.org/10.1111/j.1525-1470.2009.00903.x
  4. Gokdemir G, Erdogan HK, Koslu A, Baksu B : Cutaneous lesions in Turkish neonates born in a teaching hospital. Indian J Dermatol Venereol Leprol 75 : 638, 2009
  5. Henriques JG, Pianetti G, Henriques KS, Costa P, Gusmao S : Minor skin lesions as markers of occult spinal dysraphisms--prospective study. Surg Neurol 63 : 8-12, 2005 https://doi.org/10.1016/j.surneu.2004.09.017
  6. Hill CA, Gibson PJ : Ultrasound determination of the normal location of the conus medullaris in neonates. AJNR Am J Neuroradiol 16 : 469-472, 1995
  7. Monteagudo B, Labandeira J, Leon-Muinos E, Carballeira I, Cabanillas M, Suarez-Amor O : Frequency of birthmarks and transient skin lesions in newborns according to maternal factors (diseases, drugs, dietary supplements, and tobacco). Indian J Dermatol Venereol Leprol 77 : 535, 2011
  8. Moosavi Z, Hosseini T : One-year survey of cutaneous lesions in 1000 consecutive Iranian newborns. Pediatr Dermatol 23 : 61-63, 2006 https://doi.org/10.1111/j.1525-1470.2006.00172.x
  9. Perlitz Y, Izhaki I, Ben-Ami M : Sonographic evaluation of the fetal conus medullaris at 20 to 24 weeks' gestation. Prenat Diagn 30 : 862-864, 2010 https://doi.org/10.1002/pd.2572
  10. Rozzelle CJ, Reed GT, Kirkman JL, Shannon CN, Chern JJ, Wellons JC 3rd, et al. : Sonographic determination of normal Conus Medullaris level and ascent in early infancy. Childs Nerv Syst 30 : 655-658, 2014 https://doi.org/10.1007/s00381-013-2310-6
  11. Sahin F, Selcuki M, Ecin N, Zenciroglu A, Unlu A, Yilmaz F, et al. : Level of conus medullaris in term and preterm neonates. Arch Dis Child Fetal Neonatal Ed 77 : F67-F69, 1997 https://doi.org/10.1136/fn.77.1.F67
  12. Sarikaya Solak S, Tukenmez Demirci G, Kivanc Altunay I, Kucukunal A : The relationship of birthmarks observed in 1000 newborns with neonatal/maternal parameters: a prospective and cross-sectional study. Turkiye Klinikleri J Med Sci 33 : 1388-1394, 2013 https://doi.org/10.5336/medsci.2013-34391
  13. Shih IH, Lin JY, Chen CH, Hong HS : A birthmark survey in 500 newborns: clinical observation in two northern Taiwan medical center nurseries. Chang Gung Med J 30 : 220-225, 2007
  14. Vettivel S : Vertebral level of termination of the spinal cord in human fetuses. J Anat 179 : 149-161, 1991
  15. Warder DE : Tethered cord syndrome and occult spinal dysraphism. Neurosurg Focus 10 : e1, 2001
  16. Warder DE, Oakes WJ : Tethered cord syndrome and the conus in a normal position. Neurosurgery 33 : 374-378, 1993
  17. Warder DE, Oakes WJ : Tethered cord syndrome: the low-lying and normally positioned conus. Neurosurg 34 : 597-600; discussion 600, 1994
  18. Wilson DA, Prince JR : John Caffey award. MR imaging determination of the location of the normal conus medullaris throughout childhood. AJR Am J Radiol 152 : 1029-1032, 1989
  19. Yamada S, Zinke DE, Sanders D : Pathophysiology of "tethered cord syndrome". J Neurosurg 54 : 494-503, 1981 https://doi.org/10.3171/jns.1981.54.4.0494
  20. Zalel Y, Lehavi O, Aizenstein O, Achiron R : Development of the fetal spinal cord: time of ascendance of the normal conus medullaris as detected bysonography. J Ultrasound Med 25 : 1397-1401, 2006 https://doi.org/10.7863/jum.2006.25.11.1397