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© 2006 by the American Institute of Ultrasound in Medicine
J Ultrasound Med 25:1397-1401 • 0278-4297

Development of the Fetal Spinal Cord

Time of Ascendance of the Normal Conus Medullaris as Detected by Sonography

Yaron Zalel, MD, Ofer Lehavi, MD, Orna Aizenstein, MD and Reuwen Achiron, MD

Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, Tel Hashomer, Israel (Y.Z., R.A.); Department of Obstetrics and Gynecology, Lis Maternity Hospital, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel (O.L.); and Department of Radiology, Tel Aviv Sourasky Medical Center, Affiliated with the Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel (O.A.).

Address correspondence to Yaron Zalel, MD, Ultrasound Unit, Department of Obstetrics and Gynecology, The Chaim Sheba Medical Center, 52621 Tel Hashomer, Israel. E-mail: zalel_y{at}netvision.net.il

Objective. The purpose of this study was to perform high-resolution sonographic examinations to determine the normal anatomic relationship of the conus medullaris (CM) of the spinal cord with the vertebral column during different stages of gestation. Methods. In this prospective study, fetal sonographic evaluations were performed between 13 and 40 weeks’ gestation. Transvaginal probes (7.5–8 MHz) or abdominal probes (5–8 MHz) were used, depending on gestational age and position of the fetus. The CM was located in coronal longitudinal sections. The positions of the kidneys and lumbosacral junction and the origin of the ribs determined the location of the vertebrae. The locations of the CM were divided into 5 groups according to their positions relative to the vertebrae. Results. A total of 110 fetuses between 13 and 40 weeks’ gestation were studied. Between 13 and 18 weeks’ gestation, the CM was situated at the level of the L4 vertebra, or more caudally, in 100% of the fetuses. At term, all fetuses showed the CM above L2. A distinct ascent of the CM was detected between 13 and 40 weeks’ gestation. The results were statistically significant (P <.0001). Conclusions. A distinguishable ascent of the CM in relation to the vertebral column during fetal life was detected.

Key Words: fetal conus medullaris • fetal spine • prenatal sonographic diagnosis

Abbreviations: CM, conus medullaris • SC, spinal cord

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Copyright © 2006 by the American Institute of Ultrasound in Medicine.