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Child has tarsal talo coalition, atrophy in foot. MRI of lumbar spine showed spondylolysthesis, lordosis. Meaning?

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Neurologist, Surgical
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my 10 year old daugther, has tarsal talo cancaneal coaliation on left foot. also she has first enuresis day and night. the also she has atrophy on her left leg. the ortohped doctor sent us to see a norologist. the norologist sent us for a MRI on Lumbar spine. the results are: Spondylolysthesis l5-s1 level 1, Spondylolysis non comresive efect Significant, Lordosis marked. what does this result mean? can this be the reason for enursis? can this be the reason for atrophy and talo cancaneal coalition?
is no one here to answer?
Posted Tue, 4 Jun 2013 in Brain Tumor
 
 
Answered by Dr. Visvanathan K 4 hours later
Hi,

the reason your neurologist asked for an MRI is to look for a condition called tethered spinal cord. Sometimes the spinal cord is much more low lying than is normal and structures like the filum terminale or lipomas in the spinal canal can tether the spinal cord and prevent it from ascending up to its normal place. As far as the MRI report goes, you have not mentioned anything about these. What seems to be there is a a congenital deficiency in the joint between L5 and S1 and one vertebrae seems to have slipped forwards as a result. Now your daughters body is trying to correct for this by maintaining an over-lordotic position - ie to maintain her centre of gravity in order to be erect and walk. Usually, Spondylolosthesis presents with low back pain, shooting leg pain and other leg symptoms because of enuresis is not a common presentation in this condition.
I hope I have given you some clarification? If you find the need to explain any of the medical jargon I have used, please do let me know.
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Follow-up: Child has tarsal talo coalition, atrophy in foot. MRI of lumbar spine showed spondylolysthesis, lordosis. Meaning? 18 hours later
Thank you.

Our neurologist wrote on his refernce to MRI that he want's to check if there is a
process that puts pressure on the roots. (she says that in several cases this can cause atrophy and shorter leg and enuresis). so is the MRI answer i mentioned above answering this question?

Our neurologist wrote on her refernce to MRI to make MRI lumbo sacarly
 
 
Answered by Dr. Visvanathan K 6 hours later
Hi,
The lower portion of the spine is called Lumbo-sacral region and this is what your neurologist has wanted to see. Further, he has asked to see if the process I described to you in my initial response was present or not.

It would be useful if you could somehow upload the MRI films and/or the scan report as well so that I can give you a more accurate answer. However, from what I can understand with your description, there is no compression on the nerves. In extreme cases of listhesis (slip of one vertebrae over the other, there is sometimes a stretch of the nerves causing symptoms. It is for this reason I want to see the films/reports. Anyway, in the absence of low back pain/leg pain isolated enuresis is unlikely in spondylolisthesis.

Hope this helps?

Above answer was peer-reviewed by
 
Follow-up: Child has tarsal talo coalition, atrophy in foot. MRI of lumbar spine showed spondylolysthesis, lordosis. Meaning? 9 hours later
How can I send you the mri films, do you have a email I can send you?
 
 
Answered by Dr. Visvanathan K 1 hour later
Hi,

You can send it to YYYY@YYYY

Regards,
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Follow-up: Child has tarsal talo coalition, atrophy in foot. MRI of lumbar spine showed spondylolysthesis, lordosis. Meaning? 43 hours later
I have just sent you by mail the MRi films.
 
 
Answered by Dr. Visvanathan K 3 hours later
Hi,

I have received the e-mail. I will need the login info to view the films.

Regards,
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Follow-up: Child has tarsal talo coalition, atrophy in foot. MRI of lumbar spine showed spondylolysthesis, lordosis. Meaning? 20 hours later
I sent you by email the login info.
 
 
Answered by Dr. Visvanathan K 7 minutes later
I am unable to login to the website for now. I will try later today from home to see if I can get in.

However, I request you to send the most relevant images or reports to YYYY@YYYY with subject line as "Attention to Dr. Visvanathan".

Also, please see if you could send the images through www.dropbox.com, it is much easier to view the images here.

I am sorry about the technicalities.

Thank you!
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Follow-up: Child has tarsal talo coalition, atrophy in foot. MRI of lumbar spine showed spondylolysthesis, lordosis. Meaning? 3 hours later
OK. I have uploaded them to dropbox, and sent to your private email a link.
also I have sent them by email to YYYY@YYYY

Thank you.
 
 
Answered by Dr. Visvanathan K 1 hour later
Hi,

Thank you for taking the trouble of sending me the images. I have had a look at them. First, the caveat that I am a Neurosurgeon and not a radiologist. From what I can make out, there is nothing on the MRI that can explain her symptom. The Spondylolisthesis that is mentioned is very minimal and as we discussed earlier, there is no compression or traction on the nerve roots at that level.

To my eye, I didn't think that there was any evidence of low lying cord or tethering. You can check in your report to see if any mention was made about the filum terminale. Again, to my eye this wasn't thickened, but you can get it reconfirmed by the radiologist.

All I can therefore say is that we haven't found out cause for her symptoms on the MRI which should be a relief as we have ruled out the need for neurosurgery.

Hope this helps
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Follow-up: Child has tarsal talo coalition, atrophy in foot. MRI of lumbar spine showed spondylolysthesis, lordosis. Meaning? 29 hours later
Thank you so much.

 
 
Answered by Dr. Visvanathan K 6 hours later
No worries. Please do let me know if you need any clarifications in the future. also, please close this question and give your rating as well if you have the time.

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