Tethered Cord Syndrome: MRI Diagnosis and Surgery

Tethered cord syndrome is a previously underrecognized condition in dogs.  Clinical signs typically present at a young age, and include chronic back pain, gait changes, transient paresthesias and sometimes incontinence.  One of the biggest challenges in this condition is diagnosis, and often it can only be confirmed with surgery.  We will discuss the current literature regarding diagnosis using dynamic MRI, and why this is still difficult due to anatomical variation amongst dogs, and lack of normal dynamic imaging studies.   Imaging recommendations will be made including sequence choice and the importance of transverse imaging through the LS spine.  Surgery is often the treatment of choice, but there is also limited evidence regarding surgical choice, and how to choose between intra and extradural transection of the filum terminale.  During this presentation we will compare imaging and surgical findings based on our experience, and help continue the conversation about the best surgical approach based on the imaging findings.