Lipomyelocele = neural placode-lipoma complex contiguous with subcutaneous fat through dysraphic defect, attaching to and tethering spinal cord

Lipomyelomeningocele = lipomyelocele + meningocele, enlargement of subarachnoid space, displacement of neural placode outside of spinal canal

Posterior spinal defect lacking skin covering ⇒ neural tissue, CSF, and meninges exposed to air

Lumbosacral (44%) > thoracolumbar (32%) > lumbar (22%) > thoracic (2%)

Low-lying cord on post-operative MR imaging does not always = clinical tethering

Arise from premature separation (dysjunction) of cutaneous ectoderm from neuroectoderm during neurulation

Profound hypodensity on CT and T1WI hyperintensity characteristic of fat

Use chemical fat saturation or inversion recovery MR techniques to confirm fat content

Paraspinal muscle fiber disruption from indirect forces ⇒ abnormal muscle T2 hyperintensity and swelling

Most commonly from MVA; also athletic injuries, blow from falling objects, direct injury

General term for any lateral curvature of spine

Short-curve scoliosis usually has underlying abnormalities; consider congenital, neoplasm, or inflammation

Long, bulky, multinodular nerve enlargement is pathognomonic for NF1

Often affects sacral or brachial plexi

5% of all Ewing tumors in spine (sacrum > rest of spine)

Usually in adolescents or younger adults

Permeative lytic lesion of vertebral body or sacrum involving vertebral body before neural arch

Lymphoreticular neoplasms with wide variety of specific diseases & cellular differentiation

Multiple types demonstrate variable imaging manifestations

Congenital trans-spatial vascular malformation of venous channels present from birth

May be mass-like, frequently enhances moderately (less than soft tissue hemangioma)

No arterial vessels within lesion, venous channels may be large

Look for phleboliths to make specific diagnosis

Congenital trans-spatial vascular malformation of lymphatic channels present from birth

Typically minimal to no enhancement, although septations may enhance, especially if previously inflamed

Fluid-fluid levels strongly suggest diagnosis

May grow rapidly if hemorrhage or concurrent viral infection

Suppuration of paraspinal soft tissue from direct extension or hematogenous dissemination of pathogens

Identification of calcified psoas abscesses suggests tuberculous paraspinal abscess

Osteolytic metastases of primary tumor to spine; bone destruction exceeds bone production ⇒ lytic rather than blastic

Lesion usually destroys posterior cortex, pedicle first

Vividly enhancing hypervascular neoplasm arising from pericytes expanding/eroding spinal canal with large soft tissue component