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Tethered Cord Syndrome

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https://www.readbyqxmd.com/read/29104840/spinal-shortening-for-recurrent-tethered-cord-syndrome-via-a-lateral-retropleural-approach-a-novel-operative-technique
#1
Jeffrey A Steinberg, Arvin R Wali, Joel Martin, David R Santiago-Dieppa, David Gonda, William Taylor
Spine shortening via vertebral osteotomy (SSVO) for recurrent tethered cord syndrome (TCS) is a novel surgical technique that avoids the complication profile associated with revision detethering. While SSVO has previously been described via a posterior approach, we describe a lateral retropleural approach for SSVO in recurrent TCS in a 21-year-old female. Our patient presented with progressive lower extremity weakness, bowel and bladder incontinence, and back pain in the setting of childhood repair of myelomeningocele and two previous detethering procedures...
August 31, 2017: Curēus
https://www.readbyqxmd.com/read/29076793/magnetic-resonance-imaging-in-the-prone-position-and-the-diagnosis-of-tethered-spinal-cord
#2
Melissa M Stamates, David M Frim, Carina W Yang, Gregory L Katzman, Saad Ali
OBJECTIVE Tethered cord syndrome (TCS) is a neurosurgical disorder with varied clinical manifestations believed to result from vascular compromise due to stretch forces on the spinal cord. Conventional supine MRI findings may include a low-lying conus medullaris, thickened or fat-infiltrated filum terminale, or lipoma; however, imaging sensitivity and specificity for tethered cord can be low. The purpose of this study was to evaluate the utility of prone MRI in the diagnosis of tethered and retethered spinal cord...
October 27, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29067499/prognosis-of-surgical-treatment-of-the-tethered-cord-syndrome-in-children
#3
Kirill Sysoev, Arsen Tadevosyan, Konstantin Samochernykh, William Khachatryan
PURPOSE: The aim of this study was to identify the factors relevant to the prognosis of the outcome of the surgical treatment of the tethered cord syndrome (TCS). METHODS: The results of surgical treatment performed on 58 children with TCS were analyzed, with follow-up periods ranging from 6 months to 5 years. The data of preoperative clinical and instrumental examinations, as well as those of intraoperative electrophysiological diagnostics and morphometry, were compared with the dynamics of the TCS clinical presentation...
October 24, 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29058245/ocular-findings-in-a-patient-with-oculofaciocardiodental-ofcd-syndrome-and-a-novel-bcor-pathogenic-variant
#4
Yujia Zhou, Antonina Wojcik, Victoria R Sanders, Bahram Rahmani, Sudhi P Kurup
PURPOSE: To report a case of OFCD associated with a de novo BCOR pathogenic variant and highlight the ocular findings and possible mechanisms. METHODS: A retrospective chart review of the patient's ocular and systemic findings was performed. The patient underwent diagnostic whole exome sequencing (WES). RESULTS: The patient had a comprehensive eye exam in infancy demonstrating bilateral congenital cataracts consisting of posterior lenticonus with a posterior cortical opacity...
October 22, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/29055742/clinical-evaluation-of-an-innovative-operative-procedure-in-treatment-of-the-tethered-cord-syndrome
#5
Yang Hou, Jiangang Shi, Yongfei Guo, Jingchuan Sun, Yuan Wang, Guodong Shi, Guohua Xu
BACKGROUND CONTEXT: The Tethered cord syndrome (TCS) characterized by urination dysfunction has long been a worldwide clinical problem, of which clinical effects remains controversial. PURPOSE: To evaluate clinical effects of an innovative surgical method for treatment of TCS. STUDY DESIGN: This is a retrospective clinical study. PATIENT SAMPLE: There were 15 patients included in this study. OUTCOME MEASURES: The visual analog scale (VAS) and the Japanese Orthopaedic Association (JOA) scores were evaluated...
October 18, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29053056/intradural-spine-surgery-may-not-carry-an-increased-risk-of-shunt-revision-compared-with-extradural-spine-surgery-in-pediatric-patients-with-myelomeningocele
#6
Elizabeth N Kuhn, Betsy Hopson, Michael J Conklin, Jeffrey P Blount
OBJECTIVE Patients with myelomeningocele are often affected by scoliosis and tethered cord syndrome, and frequently require spine surgery. Intradural spine surgeries may carry an inherently higher risk of inducing shunt malfunction due to entry into the subarachnoid space. In this study, the authors sought to compare rates of shunt malfunction after intradural and extradural spine surgeries among pediatric patients with myelomeningocele. METHODS The authors reviewed records of the National Spina Bifida Program Registry for Children's Hospital of Alabama...
October 20, 2017: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29048729/beyond-down-syndrome-phenotype-paternally-derived-isodicentric-chromosome-21-with-partial-monosomy-21q22-3
#7
Manesha Putra, Urvashi Surti, Jie Hu, Deana Steele, Michele Clemens, Devereux N Saller, Svetlana A Yatsenko, Aleksandar Rajkovic
Inverted isodicentric chromosome 21 is a rare form of chromosomal rearrangement that may result in trisomy 21; sometimes this rearrangement may also lead to segmental monosomy of the terminal long arm of chromosome 21. In this report, we describe the prenatal diagnosis and neonatal follow-up of a child with a paternally derived, de novo isodicentric chromosome 21 and a concurrent ∼1.2 Mb deletion of the 21q22.3 region [46,XX,idic(21)(q22.3)]. This child presented with unusual phenotype of Down syndrome and additional defects including esophageal atresia and tethered cord syndrome...
December 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28984782/chiari-type-i-malformation-with-occult-tethered-cord-syndrome-in-a-child-a-case-report
#8
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
#9
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
#10
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
#11
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...
November 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
#12
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
#13
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
#14
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
#15
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
#16
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...
November 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
#17
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
#18
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
#19
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
#20
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
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