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Tethered Cord Syndrome

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https://www.readbyqxmd.com/read/28984782/chiari-type-i-malformation-with-occult-tethered-cord-syndrome-in-a-child-a-case-report
#1
Yuan Zhou, Lin Zhu, Yixing Lin, Huilin Cheng
RATIONALE: Chiari type I malformation (CM1) and occult tethered cord syndrome (OTCS) are considered to be malformations associated with subtle structural abnormalities of the terminal filum. Few studies have reported patients with CM1 and OTCS. Treatment strategy for patients of CM1 associated with OTCS is controversial. PATIENT CONCERNS: A 14-year-old child was admitted with intermittent pain and numbness in the right upper limb. And he had urinary frequency, neck pain, back pain, and numbness simultaneously...
October 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28961973/transhiatal-approach-to-filum-terminale-externum-sectioning-in-adult-patient-with-tethered-cord-syndrome-case-report
#2
Vanni Veronesi, Carlo Sacco, Cristina Mastronicola, Guido Staffa
BACKGROUND AND IMPORTANCE: An adult patient was referred to our department for tethered cord syndrome. A lumbar magnetic resonance imaging showed a conus medullaris at the S2 level and the caudal part of the dural sac at the S3 level. We present a minimally invasive spine surgery procedure at the hiatus level for the treatment of tethered cord syndrome by the surgical section of the filum terminale externum, which avoids bone demolition. CLINICAL PRESENTATION: A 65-yr-old Caucasian man was referred for dysesthesia and a burning sensation in his lower limbs, which was both spontaneous and triggered by contact with his clothes...
August 22, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28868301/dynamic-lumbosacral-magnetic-resonance-imaging-in-a-dog-with-tethered-cord-syndrome-with-a-tight-filum-terminale
#3
Steven De Decker, Vicky Watts, David M Neilson
A 1-year and 11-month- old English Cocker Spaniel was evaluated for clinical signs of progressive right pelvic limb lameness and urinary incontinence. Neurological examination was suggestive of a lesion localized to the L4-S3 spinal cord segments. No abnormalities were seen on magnetic resonance imaging (MRI) performed in the dog in dorsal recumbency and the hips in a neutral position and the conus medullaris ended halfway the vertebral body of L7. An MRI of the hips in extended and flexed positions demonstrated minimal displacement of the conus medullaris in the cranial and caudal directions, respectively...
2017: Frontiers in Veterinary Science
https://www.readbyqxmd.com/read/28862518/optimal-stimulation-parameters-for-intraoperative-bulbocavernosus-reflex-in-infants
#4
Hyeoncheol Hwang, Kyu-Chang Wang, Moon Suk Bang, Hyung-Ik Shin, Seung-Ki Kim, Ji Hoon Phi, Ji Yeoun Lee, Jinwoo Choi, Seungwoo Cha, Keewon Kim
OBJECTIVE The aim of this study was to establish optimal electric stimulation parameters for intraoperatively monitoring the bulbocavernosus reflexes (BCRs) in infants. METHODS The authors retrospectively reviewed the medical records of all infants (age < 24 months) who had undergone an untethering operation for tethered cord syndrome between May 2013 and February 2014 at a single institution and whose baseline BCR had been elicited during surgery. Using different combinations of stimulation parameters-number of stimulation pulses: 4 or 8 pulses, interpulse interval: 1, 2, or 5 msec, and polarity of stimulation: biphasic or monophasic-the authors compared the relative mean amplitude of 10 BCR responses (rmaBCRs) to each combination of parameters...
September 1, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28817819/progressive-kyphosis-associated-with-tethered-cord-syndrome-treated-by-posterior-vertebral-column-resection-in-a-pediatric-patient
#5
Kadir Oktay, Kerem Mazhar Ozsoy, Yurdal Gezercan, Nuri Eralp Cetinalp, Tahsin Erman
Posterior vertebral column resection is a novel surgical approach for the treatment of progressive kyphosis associated with tethered cord syndrome that was first treated with untethering surgery. A patient with tethered cord syndrome associated with kyphosis first underwent untethering surgery, resulting in progressive kyphosis. Posterior vertebral column resection was performed to correct the kyphosis while shortening the spinal column to prevent the spinal cord from stretch injury. Good correction of kyphosis and reduction of tension on the neural elements were achieved without any neurological deficits...
2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28792087/evaluation-and-management-of-tethered-cord-syndrome-in-occult-spinal-dysraphism-recommendations-from-the-international-children-s-continence-society
#6
REVIEW
Gerald F Tuite, Dominic N P Thompson, Paul F Austin, Stuart B Bauer
AIMS: As awareness and frequency of tethered spinal cord (TSC) related to occult spinal dysraphism (OSD) has increased with magnetic resonance imaging (MRI), variability exists in its evaluation and management. Due to no published level I data, we summarize the current International Children's Continence Society (ICCS) recommendations for diagnosis and treatment of OSD. METHODS: Guidelines were formulated based on analysis of pertinent literature and consensus among authors...
August 9, 2017: Neurourology and Urodynamics
https://www.readbyqxmd.com/read/28789957/mini-open-spinal-column-shortening-for-the-treatment-of-adult-tethered-cord-syndrome
#7
Michael M Safaee, Ethan A Winkler, Dean Chou
Tethered cord syndrome (TCS) is a challenging entity characterized by adhesions at the caudal spinal cord that prevent upward movement during growth and result in stretching of the cord with a concomitant constellation of neurologic symptoms. Although growth in height stops in adulthood, some patients still develop progressive symptoms; many underwent detethering as a child or adolescent, resulting in significant scar tissue and re-tethering. Recent strategies have focused on spinal column shortening to reduce tension on the spinal cord without exposing the previous de-tethering site...
October 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28782691/first-case-of-autonomic-dysreflexia-following-elective-lower-thoracic-spinal-cord-transection-in-a-spina-bifida-adult
#8
Juanita Garces, Mansour Mathkour, Tyler Scullen, Lora Kahn, Erin Biro, Alex Pham, Olawale A R Sulaiman, Roger Smith, Cuong J Bui
BACKGROUND: Spinal cord transection is a radical but effective treatment for highly selective cases of symptomatic spinal retethering in paraplegic spina bifida patients. Autonomic dysreflexia (AD) is a potentially life-threatening syndrome involving a dysregulated sympathetic discharge reflex commonly seen following cervical and high thoracic spinal cord injury, leading to a disconnect between autonomic pathways above and below the lesion that can lead to severe complications including uncontrolled hypertension, bradycardia, stroke, and potentially death...
August 3, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28695338/management-of-concomitant-scoliosis-and-tethered-cord-syndrome-in-non-spina-bifida-pediatric-population
#9
REVIEW
Kaan Yaltırık, Najib E El Tecle, Matthew J Pierson, Aki Puryear, Basar Atalay, Samer K Elbabaa
BACKGROUND: The management of concomitant scoliosis and tethered cord syndrome in the non-spina bifida pediatric population is challenging. In the present study, we evaluate the efficacy of different treatment modalities and propose a treatment plan for the management of affected patients. METHODS: A systematic literature review was conducted by querying the MEDLINE, PubMed, Cochrane, EMBASE, Scopus, and Web of Science databases for papers published between January 1996 and June 2016 and reporting on concomitant scoliosis and tethered cord...
July 10, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28686126/impact-of-magnetic-resonance-imaging-and-urodynamic-studies-on-the-management-of-sacrococcygeal-dimples
#10
Goichiro Tamura, Nobuhito Morota, Satoshi Ihara
OBJECTIVE Sacrococcygeal dimples in neonates and infants are of uncertain pathological import. Previously they were believed to be rarely associated with intraspinal anomalies. Recent studies using MRI, however, revealed that 6%-7% of pediatric cases of sacrococcygeal dimples were associated with anatomical tethered spinal cord (TSC). Because the prevalence of tethered cord syndrome is still unclear, there is no consensus among pediatric neurosurgeons on the management of children with sacrococcygeal dimples...
September 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28603378/application-of-extracorporeal-shockwaves-in-the-treatment-of-scoliosis-a-case-report
#11
Hans-Rudolf Weiss
[Purpose] In a pilot investigation, extracorporeal shockwave therapy was applied to patients with idiopathic scoliosis. This case report aimed to describe the effects of repeated extracorporeal shockwave therapy on the clinical signs of a patient with scoliosis due to a functional tethered cord syndrome. [Subject and Methods] In June 2016, a 13-year-old girl presented with a left thoracic curvature. Radiograph showed a left thoracic curve of 24°. An angle of trunk rotation of 21° was measured using a scoliometer...
May 2017: Journal of Physical Therapy Science
https://www.readbyqxmd.com/read/28553382/klippel-feil-syndrome-associated-with-sacral-agenesis-low-lying-cord-lipomyelomeningocele-and-split-cord-malformation-presenting-with-tethered-cord-syndrome-pentads-neural-tube-defects-spread-along-whole-spinal-axis
#12
Guru Dutta Satyarthee, Amandeep Kumar
Neural tube defects are congenital development anomaly of the central nervous system and usually have relatively more predilection to affect at anterior and posterior neuropore embryological development sites, so usually one or two defects are commonly encountered. However, occurrence of simultaneous multiple neural tube defects is very rare, presence of constellation of five neural defects is extremely rare, and all defects add up together to produce gross neurological deficit. We present an interesting case of a 23-year-old male who presented with history of lower backache and noticed wasting and weakness of lower limbs associated with difficulty in walking for the last 2 years but had no associated sphincter disturbances...
January 2017: Journal of Pediatric Neurosciences
https://www.readbyqxmd.com/read/28546867/tethered-cord-syndrome-with-spina-bifida-aperta-in-cats-two-case-reports-of-different-types
#13
Masahiro Tamura, Takashi Oji, Satoshi Une, Makiko Mukaino, Tatsuro Bekki, Masaki Tado, Hiromi Koyama, Yumiko Kagawa, Mutsumi Kawata
CASE SUMMARY: Two castrated male cats, aged 8 months old (case 1) and 10 months old (case 2), showed a history of progressive paraparesis, an over-reaching pelvic limb gait, urinary incontinence and a palpable dermoid fistula. In case 1, the fistula was connected to the dural sac on the conus medullaris, and the tethered spinal cord was retracted caudally. In case 2, the tubular structure was connected to the dural sac on the thoracic spinal cord, and the tethered spinal cord was retracted dorsally...
January 2017: JFMS open reports
https://www.readbyqxmd.com/read/28433844/neurologic-decline-in-an-older-patient-with-repaired-myelomeningocele-complicated-with-lumbar-canal-stenosis
#14
Shingo Matsuda, Satoshi Yamaguchi, Yosuke Kajihara, Masaaki Takeda, Manish Kolakshyapati, Kaoru Kurisu
BACKGROUND: Tethered cord syndrome is a well-known complication after myelomeningocele (MMC) repair in childhood. However, late complications in adults with a repaired MMC are not well understood. In particular, the influence of a degenerative spinal deformity on a sustained tethered cord is still unclear. CASE DESCRIPTION: A 63-year-old man with a repaired MMC exhibited a progressive gait disturbance and numbness in both lower limbs. Magnetic resonance imaging demonstrated that the tethered spinal cord was compressed by severe canal stenosis along the entire lumbar spine...
July 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28362188/spinal-column-shortening-for-tethered-cord-syndrome-associated-with-myelomeningocele-lumbosacral-lipoma-and-lipomyelomeningocele-in-children-and-young-adults
#15
Guillermo Aldave, Daniel Hansen, Steven W Hwang, Amee Moreno, Valentina Briceño, Andrew Jea
OBJECTIVE Tethered cord syndrome is the clinical manifestation of an abnormal stretch on the spinal cord, presumably causing mechanical injury, a compromised blood supply, and altered spinal cord metabolism. Tethered cord release is the standard treatment for tethered cord syndrome. However, direct untethering of the spinal cord carries potential risks, such as new neurological deficits from spinal cord injury, a CSF leak from opening the dura, and retethering of the spinal cord from normal scar formation after surgery...
June 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/28342704/trends-in-the-presentation-surgical-treatment-and-outcomes-of-tethered-cord-syndrome-a-nationwide-study-from-2001-to-2010
#16
Cyrus M Jalai, Charles Wang, Bryan J Marascalchi, Samantha R Horn, Gregory W Poorman, Olivia J Bono, Anthony K Frempong-Boadu, Peter G Passias
OBJECTIVE: This is a nationwide query into surgical management techniques for tethered cord syndrome, focusing on patient demographic, hospital characteristics, and treatment outcomes. Our hypothesis is that detethering vs. fusion for TCS results in different in-hospital complications. MATERIALS AND METHODS: Retrospective review of the Nationwide Inpatient Sample 2001-2010. Inclusion: TCS discharges undergoing detethering or fusion. Sub-analysis compared TCS cases by age (pediatric [≤9years] vs...
July 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28322501/multigenerational-pedigree-with-star-syndrome-a-novel-fam58a-variant-and-expansion-of-the-phenotype
#17
Nicole J Boczek, Teresa Kruisselbrink, Margot A Cousin, Patrick R Blackburn, Eric W Klee, Ralitza H Gavrilova, Brendan C Lanpher
STAR syndrome is a rare X-linked dominant disorder characterized by toe Syndactyly, Telecanthus, Anogenital malformations, and Renal malformations, and is caused by loss-of-function variants in FAM58A. Our proband presented with the hallmark features of STAR syndrome, as well as some additional less typical features including tethered cord and hearing loss. The proband's mother and maternal half-sister had similar clinical histories, but had variability in phenotypic severity. Clinical whole exome sequencing revealed a novel pathogenic nonsense variant, c...
May 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28293750/factors-affecting-the-surgical-outcomes-of-tethered-cord-syndrome-in-adults-a-retrospective-study
#18
Anas Abdallah, Erhan Emel, Betül Güler Abdallah, Murad Asiltürk, Özden Erhan Sofuoğlu
This study aimed to find the factors that may affect the surgical outcomes of congenital tethered cord syndrome (TCS) in adults by evaluating the long-term surgical outcomes of 25 consecutive cases. Medical records of 79 TCS cases which underwent surgery in Bakırköy Research and Training Hospital for Neurology, Neurosurgery and Psychiatry (BRSHH), during an 11-year period from 2005 to 2015, were retrospectively reviewed. All adult cases (patient age > 18 years) were selected as the core sample used for this study...
March 14, 2017: Neurosurgical Review
https://www.readbyqxmd.com/read/28279771/recurrent-abortion-and-tethered-cord-syndrome-caused-by-anterior-sacral-meningocele-a-report-of-a-rare-case-with-a-review-of-the-literature
#19
REVIEW
Shruti Gupta, Jayesh Chunnilal, Manasi Mehrotra, Anant Mehrotra, Arun K Srivastava, Kuntal K Das
BACKGROUND: Anterior sacral meningocele is a rare congenital anomaly. CASE DESCRIPTION: This rare anomaly is described in a young woman who presented with recurrent abortion and later with a huge palpable mass of pelvic origin, measuring 14 × 12 cm. CONCLUSIONS: The various radiologic features, associations such as presacral dermoid as a part of incomplete Currarino syndrome, and the management options available are also discussed.
May 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28220607/neurological-and-spinal-manifestations-of-the-ehlers-danlos-syndromes
#20
REVIEW
Fraser C Henderson, Claudiu Austin, Edward Benzel, Paolo Bolognese, Richard Ellenbogen, Clair A Francomano, Candace Ireton, Petra Klinge, Myles Koby, Donlin Long, Sunil Patel, Eric L Singman, Nicol C Voermans
The Ehlers-Danlos syndromes (EDS) are a heterogeneous group of heritable connective tissue disorders characterized by joint hypermobility, skin extensibility, and tissue fragility. This communication briefly reports upon the neurological manifestations that arise including the weakness of the ligaments of the craniocervical junction and spine, early disc degeneration, and the weakness of the epineurium and perineurium surrounding peripheral nerves. Entrapment, deformation, and biophysical deformative stresses exerted upon the nervous system may alter gene expression, neuronal function and phenotypic expression...
March 2017: American Journal of Medical Genetics. Part C, Seminars in Medical Genetics
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