Differential Diagnosis:
Further Work-up
MRI Lumbar Spine
- Imperforate anus
- VATER (vert defects, anal atresia, TE fist, Esophageal Atresia, Renal Dysplasia
- Caudal regression syndrome
- Conus Lipoma (75%): Lipomyelocele, Lipomyelocystocele, Lipomyelomengiocele
- Filum Terminale Lipoma (20%)
- Intradural Sub-pial Lipoma (5%)
Filum Terminale lipomas are typically occult, have no cutaenous stigmata and may present as an incidental finding on 1% of all MR’s. The natural hx of asymptomatic tethered cord in general not well understood, but general consensus is of progression and once symptomatic, detethering serves to prevent progression of symptoms rather than symptom reversal. Offer a detethering and leave the lipoma alone vs. follow clinically and w/urodynamics