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Tethered Cord Syndrome

Daniele Starnoni, John Michael Duff, Gopalakrishnan Chittur Viswanathan
CONTEXT: Anatomical variations of the filum terminale (FT) have been described in association with split cord malformations (SCM) but they appear to be a rare finding in its absence. We report the first case in literature of a duplicated FT in a patient presenting with tethered cord syndrome (TCS) without any radiological evidence of SCM. FINDINGS: A 47-year-old man presented with invalidating back pain radiating to both legs. Magnetic resonance imaging revealed an intradural dorsal lipoma in a low-lying conus...
October 13, 2016: Journal of Spinal Cord Medicine
Arlene Lazaro, Miguel X Escalon, Mariam Zakhary
No abstract text is available yet for this article.
September 2016: PM & R: the Journal of Injury, Function, and Rehabilitation
Qiu-Jiong Zhao, Shao-Cong Bai, Cheng Cheng, Ben-Zhang Tao, Le-Kai Wang, Shuang Liang, Ling Yin, Xing-Yi Hang, Ai-Jia Shang
Copy number variations have been found in patients with neural tube abnormalities. In this study, we performed genome-wide screening using high-resolution array-based comparative genomic hybridization in three children with tethered spinal cord syndrome and two healthy parents. Of eight copy number variations, four were non-polymorphic. These non-polymorphic copy number variations were associated with Angelman and Prader-Willi syndromes, and microcephaly. Gene function enrichment analysis revealed that COX8C, a gene associated with metabolic disorders of the nervous system, was located in the copy number variation region of Patient 1...
August 2016: Neural Regeneration Research
Mehmet Selcuki, Mesut Mete, Deniz Selcuki
AIM: The Chiari Malformation I (CM I) and tethered cord syndrome (TCS) are both congenital abnormalities whose mechanism are still not fully understood. Associaton of CM I and TCS have been reported only for a few times previously Material and Methods: This retrospective study includes 7 patients who were diagnosed with CM I and TCS managed by cutting of the filum terminale. RESULTS: The mean follow-up period was 21 months and 28 days. Although all patients were undergone untethering surgical procedure by cutting the filum terminale only, all patients reported significant early postsurgical resolution of CM I symptoms and symptoms related to TCS as well...
July 1, 2016: Turkish Neurosurgery
Serhat Pusat, Cahit Kural, Ilker Solmaz, Caglar Temiz, Yunus Kacar, Ozkan Tehli, Murat Kutlay, Mehmet Daneyemez, Yusuf Izci
AIM: Electrophysiological evaluation of the outcomes of spinal procedures is important for neurosurgeons. Somotosensorial evoqued potentials (SSEPs) are used for electrophysiological evaluation of tethered cord syndrome (TCS) and spinal intradural tumors (SIT). The aim of this study is to document the electrophysiological outcomes of surgery for TCS and SIT and to compare the results based on the preoperative diagnosis. MATERIAL AND METHODS: The data of 30 patients, who were operated for TCS and SIT between 2011 and 2013, were reviewed retrospectively...
February 5, 2016: Turkish Neurosurgery
Özden Erhan Sofuoğlu, Anas Abdallah, Erhan Emel, Ali Ender Ofluoğlu, Müslüm Güneş, Betül Güler
OBJECTIVE AND BACKGROUND: Tethered cord syndrome (TCS) in adults is rarely diagnosed as well as it is a complex clinicopathological entity that remains poorly understood. In this study, clinical outcomes of 23 consecutive congenital TCSs diagnosed in adults have been evaluated to establish a standard approach to treat congenital TCS diagnosed in adults. METHODS: Medical records were retrospectively reviewed in 73 cases of tethered cord syndrome whom underwent surgery in our hospital, between the years 2005 and 2014...
October 2, 2015: Turkish Neurosurgery
Noorulain Iqbal, Mohsin Qadeer, Salman Yousuf Sharif
STUDY DESIGN: Fifty patients surgically treated for tethered cord syndrome (TCS) were retrospectively studied at Liaquat National Hospital, Karachi from 2010 until 2014. PURPOSE: To assess the common presentations of TCS in our part of the world and the surgical outcome of the different presentations. OVERVIEW OF LITERATURE: TCS is a stretch-induced functional disorder of the spinal cord with its caudal part anchored by an inelastic structure, which results in characteristic symptoms and signs...
August 2016: Asian Spine Journal
Hiroaki Nakashima, Shiro Imagama, Hiroki Matsui, Yasutsugu Yukawa, Koji Sato, Tokumi Kanemura, Mitsuhiro Kamiya, Kenyu Ito, Yukihiro Matsuyama, Naoki Ishiguro, Fumihiko Kato
STUDY DESIGN: Retrospective multicenter study. OBJECTIVE: Although untethering surgery has been a standard treatment in patients with adult tethered cord syndrome (TCS), spine-shortening osteotomy (SSO) has recently been performed as an alternative technique. The purpose of this study was to compare the clinical outcomes of the two procedures for TCS in adults. METHODS: Fourteen patients (37.7 ± 12.5 years) with TCS were enrolled at 6 hospitals...
September 2016: Global Spine Journal
Fatu S Conteh, Rachana Tyagi, Susan S Brooks
No abstract text is available yet for this article.
August 22, 2016: Clinical Dysmorphology
C Corbett Wilkinson, Arianne J Boylan
INTRODUCTION: The most commonly used classification system for caudal appendages (aka human tails) dates from the 1980s and classifies appendages (tails) as either true tails or pseudotails. Advances in neuroimaging since the 1980s, however, as well as an ever-increasing number of reported cases, have made this system outdated. Sacrococcygeal eversion is a condition in which the distal sacral and coccygeal vertebrae are curved in a retroverted rather than anteverted direction. It can give rise to one type of caudal appendage...
August 6, 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Jing-Jie Liu, Zheng Guan, Zhen Gao, Li Xiang, Feng Zhao, Sheng-Li Huang
Since little has been reported about complications of spinal anesthesia in adult tethered cord syndrome (TCS), we sought to delineate the characteristics of the condition.A total of 4 cases of adult TCS after spinal anesthesia were reviewed. The medical charts of the patients were obtained. Anesthesia, which was combined spinal and epidural anesthesia or spinal anesthesia was performed, and follow-up were carried out in all patients.The most common neurological symptom of adult TCS before surgery was occasional severe pain in back, perineal region, or legs...
July 2016: Medicine (Baltimore)
Prashant Shankar, Carlos Zamora, Mauricio Castillo
In this chapter we briefly address the most common congenital brain and spinal anomalies as well as their most salient imaging, especially magnetic resonance, findings. Some of them, such as Chiari II, and open spinal defects, have become relatively rare due to their detection in utero and repair of the spinal malformation. Regardless of the type of brain anomaly, the most common clinical symptoms are mental retardation, hydrocephalus, and seizure; the latter two may need to be surgically and medically addressed...
2016: Handbook of Clinical Neurology
Nancy Abu-Bonsrah, Taylor E Purvis, C Rory Goodwin, Rory J Petteys, Rafael De la Garza-Ramos, Daniel M Sciubba
Lipomyelomeningocele (LMM) as a cause of tethered cord syndrome (TCS) commonly presents in childhood in the lumbosacral spine. Patients frequently present with cutaneous manifestations, progressive neurological deterioration, bladder dysfunction, and intractable pain. Early surgical intervention with untethering is recommended for symptomatic patients. We report an unusual case of a woman who presented with a subcutaneous lump, pain, and neurological decline found to have a cervicothoracic LMM. The patient underwent laminectomy and subtotal resection of the mass; seventeen years later she was confined to a wheelchair with severe neurological decline ultimately requiring three additional attempts at surgical excision and repair...
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Ved Prakash Maurya, Medha Rajappa, Vaibhav Wadwekar, Sunil K Narayan, Deepak Barathi, Venkatesh S Madhugiri
OBJECTIVE: Several studies have assessed clinical and radiologic outcomes after detethering of the cord for tethered cord syndrome (TCS). However, no data regarding the impact of detethering on the metabolism or electrophysiologic functioning of the cord is available. The aim of this study was to assess the changes in the cerebrospinal fluid (CSF) levels of markers of neuronal injury and alterations in the electrophysiologic functioning of the spinal cord after detethering. METHODS: This prospective study included patients with congenital TCS...
July 12, 2016: World Neurosurgery
Osama Kashlan, D Andrew Wilkinson, Hal Morgenstern, Cormac O Maher
INTRODUCTION: Isolated tethered cord syndrome (iTCS) may be diagnosed in a symptomatic patient with a low-lying conus caused by a tight and/or fatty filum. Its incidence, patient characteristics, and outcomes after treatment with untethering surgery have been described largely through single-center studies. Indications for and the proper timing of surgery remain a subject of debate. METHODS: Utilizing the Optum Insight data set, we examined all pediatric patients in a large nationwide health care network with an International Classification of Diseases (ICD) diagnosis code of tethered cord between 2001 and 2014 (n = 3218)...
August 2016: Neurosurgery
K V Sysoev, A R Tadevosyan, Yu V Nazinkina, V A Khachatryan
AIM: The study objective was to identify factors affecting surgical treatment outcomes in children with tethered cord syndrome (TCS). MATERIAL AND METHODS: The study included 21 TCS patients aged 1 to 14 years who underwent tethered cord release. The preoperative and postoperative data of clinical and neurophysiological examination and high field (3T) MRI tractography of the caudal spinal cord were compared. RESULTS: Regression of the TCS clinical and electrophysiological signs and the lack of pathological changes in the spinal cord tracts were observed in patients with filum terminale abnormalities and caudal lipomas after surgery...
2016: Zhurnal Voprosy Neĭrokhirurgii Imeni N. N. Burdenko
Ha Son Nguyen, Andrew Foy, Peter Havens
BACKGROUND: Surgery is routinely recommended for lumbar lipomyelomeningocele, especially in the setting of tethered cord syndrome. The most common complications are wound infections and cerebrospinal fluid (CSF) leak, which remain confined to the surgical site. To the best of our knowledge, there have been no prior reports relating an intracranial subdural empyema following detethering surgery. Prompt diagnosis is essential since subdural empyema is a neurosurgical emergency. CASE DESCRIPTION: The patient was an 11-month-old male who underwent detethering surgery for a lumbar lipomyelomeningocele...
2016: Surgical Neurology International
Glenda Hendson, Christopher Dunham, Paul Steinbok
PURPOSE: To compare histologically transected fila from pediatric patients with tethered cord syndrome (TCS), with and without a low conus, with controls, focusing on collagenous and elastic tissue. METHODS: Thirty fila from patients with TCS, including 5 where minimal cautery was used prior to filum section, were compared with fila from 27 pediatric cadavers without TCS (controls). Sections of fila were stained with H&E, Masson trichrome and Verhoeff von Gieson elastic stains, and 7 with Gordon and Sweet's reticulin stain...
September 2016: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Semra Işik, Baran Yilmaz, Murat Şakir Ekşi, Emel Ece Özcan-Ekşi, Akin Akakin, Zafer Orkun Toktaş, Mustafa Kemal Demir, Deniz Konya
In this case-based review, the authors analyzed relevant literature with an illustrative patient of theirs about subdural hematoma secondary to dural tear at spinal surgery. Intracranial hypotension is a condition of decreased cerebrospinal fluid volume and pressure. Even though intracranial hypotension is temporary and can be managed conservatively, it may progress and result in subdural fluid collections, hematoma formations, "brain sagging or slumping" states, syringohydromyelia, encephalopathy, coma, and even death...
June 2016: Journal of Craniofacial Surgery
Arvind Jayaswal, Pankaj Kandwal, Ankur Goswami, G Vijayaraghavan, Ashok Jariyal, B N Upendra, Ankit Gupta
OBJECTIVE: To evaluate clinical and radiological outcomes of growing rod (GR) in the management of Early Onset Scoliosis (EOS) with intraspinal anomalies. BACKGROUND DATA: The effect of repeated distractions following GR, in the presence of intraspinal anomalies has not been studied. METHODS: During 2007-2012, 46 patients underwent fusionless surgery. Out of these 46 patients, 13 patients had one or more intraspinal anomalies. 11 patients had undergone prior neurosurgical procedure while 2 (filum terminale lipoma and syringomyelia) did not...
April 12, 2016: European Spine Journal
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