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Tethered Cord Syndrome

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https://www.readbyqxmd.com/read/29879784/surgical-outcomes-of-pediatric-patients-with-asymptomatic-tethered-cord-syndrome
#1
Toshitaka Seki, Kazutoshi Hida, Shunsuke Yano, Kiyohiro Houkin
STUDY DESIGN: A retrospective cohort study. PURPOSE: To examine the validity of prophylactic surgery for children with tethered cord syndrome (TCS). OVERVIEW OF LITERATURE: Prophylactic surgery for pediatric patients with TCS remains controversial. METHODS: We retrospectively analyzed the surgical outcomes of 14 children (nine boys and five girls) with asymptomatic TCS who were surgically treated at Hokkaido University Hospital between 1989 and 2015...
June 2018: Asian Spine Journal
https://www.readbyqxmd.com/read/29802712/morphometric-parameters-and-histological-study-of-the-filum-terminale-of-adult-human-cadavers-and-mr-images
#2
Ashraf Youssef Nasr, Adel Mostafa Hussein, Said Ahmed Zaghloul
BACKGROUND: Morphology and histology of filum terminale (FT) has a role in the pathophysiology of TCS. OBJECTIVE: This research was implemented to investigate the morphometric parameters and histological structure of normal FT in adult human cadavers and MRI scans to correlate them with the pathophysiology of tethered cord syndrome (TCS). MATERIALS AND METHODS: twenty five adult human cadavers (15 males &10 females) and 100 MR echo scans of lumbosacral region (50 males and 50 females), were used for this study...
May 26, 2018: Folia Morphologica (Warsz)
https://www.readbyqxmd.com/read/29797063/mechanical-relationship-of-filum-terminale-externum-and-filum-terminale-internum-is-it-possible-to-detether-the-spinal-cord-extradurally
#3
Mayank Patel, Marc Vetter, Emily Simonds, Maia Schumacher, Tyler Laws, Joe Iwanaga, Rod Oskouian, R Shane Tubbs
INTRODUCTION: Intradural transection of the filum terminale (FTI) is often used to treat tethered cord syndrome. Recently, some have proposed that the extradural part of the filum terminale (FTE) can be sectioned with equal results but with fewer complications. Therefore, the present cadaveric study aimed to evaluate the anatomical foundation of such procedures. METHODS: A posterior lumbosacral approach was performed on five fresh-frozen cadaveric specimens to expose both the FTI and FTE...
May 24, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/29774817/bladder-reconstruction-with-bowel-robot-assisted-laparoscopic-ileocystoplasty-with-mitrofanoff-appendicovesicostomy-in-pediatric-patients
#4
Nimrod S Barashi, Maria Veronica Rodriguez, Vignesh T Packiam, Mohan S Gundeti
Neurogenic bladder occur as a consequence of several conditions, most commonly posterior urethral valves syndrome, spina bifida, tethered cord, sacral agenesis, and Arnold-Chiari malformation. It is characterized by diminished bladder capacity and/or reduced compliance, associated with high-pressure voiding that can lead to deterioration of renal function if left untreated. When medical management fails, bladder reconstruction with bowel (aumentation ileocystoplasty) becomes the treatment of choice for these patients...
May 2018: Journal of Endourology
https://www.readbyqxmd.com/read/29732422/developments-in-the-treatment-of-chiari-type-1-malformations-over-the-past-decade
#5
Peter G Passias, Alexandra Pyne, Samantha R Horn, Gregory W Poorman, Muhammad B Janjua, Dennis Vasquez-Montes, Cole A Bortz, Frank A Segreto, Nicholas J Frangella, Matthew Y Siow, Akhila Sure, Peter L Zhou, John Y Moon, Bassel G Diebo, Shaleen N Vira
Background: Chiari malformations type 1 (CM-1), a developmental anomaly of the posterior fossa, usually presents in adolescence or early adulthood. There are few studies on the national incidence of CM-1, taking into account outcomes based on concurrent diagnoses. To quantify trends in treatment and associated diagnoses, as retrospective review of the Kid's Inpatient Database (KID) from 2003-2012 was conducted. Methods: Patients aged 0-20 with primary diagnosis of CM-1 in the KID database were identified...
March 2018: Journal of Spine Surgery (Hong Kong)
https://www.readbyqxmd.com/read/29731315/multiple-neurosurgical-treatments-for-different-members-of-the-same-family-with-currarino-syndrome
#6
N Serratrice, L Fievet, F Albader, D Scavarda, H Dufour, S Fuentes
INTRODUCTION: Currarino's syndrome (CS) is an autosomal dominant disorder of embryonic development causing a rare malformating syndrome characterized by a triad of an anorectal malformations, presacral mass (most commonly an anterior sacral meningocele) and sacral bony defects. Mutations of the HLXB9 gene have been identified in most CS cases, but a precise genotype-phenotype correlation has not been described so far. Family screening is obligatory. The diagnosis is usually made during childhood and rarely in adulthood...
May 3, 2018: Neuro-Chirurgie
https://www.readbyqxmd.com/read/29682019/adult-versus-pediatric-tethered-cord-syndrome-clinicoradiological-differences-and-its-management
#7
Mukesh Shukla, Jayesh Sardhara, Rabi Narayan Sahu, Pradeep Sharma, Sanjay Behari, Awadesh Kumar Jaiswal, Arun Kumar Srivastava, Anant Mehrotra, Kuntal Kanti Das, Kamlesh Singh Bhaisora
Background: Dysraphic lesions in adults, presenting clinically as tethered cord syndrome (TCS), are relatively rare, and their optimal management remains controversial. Patients and Methods: We performed a retrospective analysis of our pediatric database over a period of last 7 years to focus on the adult TCS. Our aim was to determine the clinicoradiological and etiopathological differences between adult and pediatric patients as well as to determine the results of surgery in adult TCS...
April 2018: Asian Journal of Neurosurgery
https://www.readbyqxmd.com/read/29678699/acute-communicating-hydrocephalus-as-spinal-cord-surgery-complication-in-patient-with-lumbar-lipomyelocele
#8
Alessandro Prior, Mariasavina Severino, Andrea Rossi, Marco Pavanello, Gianluca Piatelli, Alessandro Consales
BACKGROUND: A lumbar lipomyelocele is a closed spinal dysraphism that can cause tethered cord syndrome. Between 5% and 15% of spinal dysraphism surgery cases are burdened with complications, the most common being wound infections or dehiscence and cerebrospinal fluid leak. Acute communicating hydrocephalus has never been described as a complication of this type of surgery. CASE DESCRIPTION: A 6-year-old girl who had undergone several surgeries in another institution for lumbar lipomyeloschisis came to our attention for a second opinion about the management of her spinal dysraphism...
April 17, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29668630/thoracolumbar-spinal-neurenteric-cyst-with-tethered-cord-syndrome-and-extreme-cervical-lordosis-in-a-child-a-case-report-and-literature-review
#9
Zhi Gang Lan, Seidu A Richard, Chuanfen Lei, Siqing Huang
RATIONALE: Neurenteric cysts, are rare benign tumors of the central nervous system that are mostly located in the spinal cord and predominantly seen in male children although adult form of the disorder also occurs. The etiology and treatment of this disorder is still a matter of debate. Our case further throws more light on the pathogenesis and treatment of this disorder. PATIENT CONCERNS: A 4-year-old boy presented with 5-month history of cervical lordosis and bilateral lower extremity pain that progressed to his abdomen and upper body...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29649647/clinical-outcomes-of-primary-and-revision-untethering-surgery-in-patients-with-tethered-cord-syndrome-and-spinal-bifida
#10
Jingchuan Sun, Yao Zhang, Haibo Wang, Yuan Wang, Yong Yang, Qingjie Kong, Ximing Xu, Jiangang Shi
BACKGROUND: Tethered cord syndrome (TCS) is an increasingly recognized clinical condition, with untethering surgery considered the classically effective treatment. Yet, as evidence has aggregated, the surgical outcomes of untethering remain controversial. This study aimed to systematically evaluate the clinical outcomes in patients who underwent primary or revision untethering. METHODS: This retrospective study was conducted at the Department of Spine Surgery of Changzheng Hospital between January and December 2016...
April 9, 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29605699/tailored-strategies-to-manage-cerebrospinal-fluid-leaks-or-pseudomeningocele-after-surgery-for-tethered-cord-syndrome
#11
Suhas Udayakumaran, Chetan T Rathod
BACKGROUND: Cerebrospinal fluid (CSF) leaks are a dreaded complication after surgery for tethered cord and are associated with significant patient morbidity. Although many strategies for managing postoperative CSF leaks exist, this problem is still daunting, especially in very young patients. In this study, we compared different management techniques for CSF leaks or significant pseudomeningocele in patients with tethered cord syndrome (TCS). METHODS: We analyzed a cohort of children who underwent surgery for TCS from January 2011 to March 2016 (n = 260) and postoperatively experienced either a CSF leak or significant pseudomeningocele...
June 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29538204/spinal-cord-infarction-caused-by-sacral-canal-epidural-steroid-injection-a-case-report
#12
Gang Wang, Jing Liang, Zishan Jia, Lei Wan, Mingxia Yang
RATIONALE: Spinal cord infarction is one of the complications of epidural steroid injections (ESIs), but has only been reported in cervical vertebra by transforaminal injection and lumbar vertebra by transforaminal injection; and up to now, there is no reporting about spinal cord infarction caused by caudal injection. Here, we report a case. PATIENT CONCERNS: A 52-year-old man was admitted to our hospital. He was diagnosed as lumbar disc herniation in other hospital, and the patient suffered bilateral lower limb motor and sensory disorders after administration of caudal ESI...
March 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29528274/spine-shortening-osteotomy-for-patients-with-tethered-cord-syndrome-a-systematic-review-and-meta-analysis
#13
Weiwei Lin, Hongtao Xu, Guman Duan, Jinjin Xie, Yisheng Chen, Baohua Jiao, Haitao Lan
Purpose Tethered cord syndrome (TCS) is the clinical manifestation of an abnormal stretch on the spinal cord, caused by several pathological conditions. Tethered cord release is the gold standard treatment for TCS. However, direct untethering carries potential risks of spinal cord injury, post-operative retethering, and CSF-related complications. Spine-shortening osteotomy (SSO) has recently been performed as an alternative technique to avoid these risks. We aimed to systematically review the literature on indications and outcome of SSO in TCS patients...
May 2018: Neurological Research
https://www.readbyqxmd.com/read/29409774/adult-tethered-cord-syndrome-following-chiari-decompression
#14
Christina Jackson, Brian W Yang, Wenya Linda Bi, E Antonio Chiocca, Michael W Groff
BACKGROUND: Adult tethered cord syndrome is a rare neurologic disorder that classically presents with back or leg pain, weakness, and urinary dysfunction. Spinal cord tethering has been associated with acquired Chiari malformations. Whereas the effects of tethered cord release on Chiari malformation symptoms have been described previously, we report an unusual case of acquired tethered cord syndrome following Chiari decompression. CASE DESCRIPTION: We report a 68-year-old man with a history of distant T12-level spinal cord injury and 2 weeks of progressive bilateral lower extremity weakness...
April 2018: World Neurosurgery
https://www.readbyqxmd.com/read/29367470/minimally-invasive-surgical-approach-to-filum-lipoma
#15
Toshiaki Hayashi, Tomomi Kimiwada, Misaki Kohama, Reizo Shirane, Teiji Tominaga
Filum terminale lipoma (FTL) causes various spinal symptoms known as tethered cord syndrome. The treatment for FTL is surgical untethering by sectioning the FTL, which can prevent symptom progression and often results in improvement of symptoms. This report describes a minimally invasive surgical strategy that we have introduced for FTL sectioning. The pediatric patients with FTL since 2007 were treated using this minimally invasive surgical strategy, which we refer to as an interlaminar approach (ILA). In summary, the surgical technique involves: minimal skin incision to expose the unilateral ligamentum flavum in the lower lumbar region; ligamentum flavum incision to expose the dural sac, and dural incision followed by identification and sectioning of the filum...
January 23, 2018: Neurologia Medico-chirurgica
https://www.readbyqxmd.com/read/29332115/ultrasound-guided-transversus-abdominis-plane-block-postoperative-analgesia-in-children-with-spinal-dysraphism
#16
Eralp Çevikkalp, Koray Erbüyün, Serpil Erbüyün, Gülay Ok
Pediatric regional anesthesia is widely used to relieve postoperative pain after abdominal surgery. Commonly used techniques of regional anesthesia include lumbar epidural and caudal block. However, the use of central neuraxial blockade has limitations. It is contraindicated in patients with clotting abnormalities, spinal dysraphism with tethered cord syndrome, meningomyelocele, and following spinal surgery with instrumentation. Ultrasound guided transversus abdominis plane block is a new method of regional anesthesia that can be used in settings where central neuraxial blockade is contraindicated...
January 2018: Saudi Medical Journal
https://www.readbyqxmd.com/read/29104840/spinal-shortening-for-recurrent-tethered-cord-syndrome-via-a-lateral-retropleural-approach-a-novel-operative-technique
#17
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
#18
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...
January 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29067499/prognosis-of-surgical-treatment-of-the-tethered-cord-syndrome-in-children
#19
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...
February 2018: 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
#20
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
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