Sagittal T1 MRI without contrast of the spine (above) shows the conus medullaris to be low in position at L5 and to be contiguous with a lipomatous mass in the posterior spinal canal with neural elements extending from the low-lying cord through a defect in the bone posteriorly and being contiguous with subcutaneous fat. Axial T1 MRI at the level of the conus (below left) shows fat adherent to the conus posteriorly and the conus / neural tissue extending into the subcutaneous fat. Axial T2 MRI at the level of the conus (below right) also shows that there is some cerebrospinal fluid extending into the subcutaneous fat as well.
