Tethered cord syndrome (TCS) is an increasingly recognized clinical disorder, which is usually identified in childhood and is defined as a stretch-induced functional disorder of the spinal cord with its caudal part anchored by an inelastic structure.1, 2, 3 The disproportionate longitudinal growth between the vertebral column and the tethered spinal cord results in ⦠Occult tethered cord syndrome presents with a constellation of symptoms consistent with TCS in the absence of radiologic evidence of tethering, and resection of the filum has been performed in the pediatric population; however, the subject and surgical indication is still a controversial matter based on the equivocal results of a randomized controlled trial , , , . The term tethered cord syndrome, as used in this chapter, signifies a pathologic fixation of the spinal cord in an abnormally low position so that the spinal cord, with activities and growth, undergoes mechanical stretching, distortion, and ischemia. Medullary cone movement in subjects with a normal spinal cord and in patients with a tethered spinal cord. Radiological case of the month. Read "Radiologic and histopathologic findings in a rare case of complex occult spinal dysraphism with association of a lumbar fibrolipoma, neurenteric cyst and tethered cord syndrome, European Radiology" on DeepDyve, the largest online rental service for scholarly research with thousands of academic publications available at your fingertips. 28. European Journal of Radiology, Vol. Tethered cord syndrome (TCS) is a clinical condition of various origins that arises from tension on the spinal cord. Specific circumstances involving either additional tugging of the already t ⦠The primary tethered cord syndrome has been documented mainly in children and adolescents but also in adults, and patients may present with backache, neuromuscular skeletal changes such as club-foot, scoliosis, muscular atrophy, disturbances of gait, or dysfunction of bladder and rectum, or a combination of these conditions. Lipomyelocele with tethered cord | Radiology Case | Radiopaedia.org Spinal dysraphism is a broad spectrum of congenital anomalies affecting the spine and cord. Garce´s-Ambrossi GL, McGirt ML, Samuels R, Sciubba DM, Bydon A, Gokaslan ZL, Jallo GI (2009) Neurological outcome after surgical management of adult tethered cord syndrome. 1 Many conditions can cause tethering of the spinal cord, including tight filum terminale, split cord ⦠2004. Discussion . 2009 Apr; 3(4):5-8 Pediatric Radiology: Osteoid osteoma of the femur: masquerading the tethered cord syndrome Agrawal et al. 2 A thorough medical history, physcial examination, imaging, and electrophysiological tests are heplful in ⦠Tethered cord syndrome in an adult: Clinical and neuroradiological features The Italian Journal of Neurological Sciences, Vol. Abstract We present an illustrative case of osteoid osteoma of the femur, in an 11 year old male child where the clinical features were masquerading the diagnosis of tethered cord syndrome and lead to the delay in diagnosis. 27. 40: 80-3. There is lack of normal cord pulsatility, and the filum terminale is thickened to over 2 mm. All cases had a sacral dimple, which is a skin stigmata, and radiological abnormalities, including fatty or thickened filum terminale. Adult onset of tethered cord syndrome is a rare pathologic entity. Giles LG(1). Occult spinal dysraphism (tethered cord, diastematomyelia, and spinal lipoma). Midline lumbar swelling since ⦠... Myelomeningocele and tethered cord. Tethered cord syndrome (TCS) is a clinical condition of various origins that arises from tension on the spinal cord. 102, No. Neurosurg Rev 31(4):371â383 5. Tethered cord syndrome (TCS) after myelomeningocele (MMC) repair (or secondary TCS) is a challenging condition characterized by neurological, orthopedic, and urological symptoms, which are combined with a low-lying position of the conus medullaris and damage to the stretched spinal cord owing to metabolic and vascular derangements. Lipomyelocele and tethered cord | Radiology Case | Radiopaedia.org Lipomyelocele is one of the types of lipomatous masses of the central nervous system (along with lipomyelomeningocele, intradural lipomas and fatty filum terminale). 220(1): 208-212. Tethered cord is a clinical syndrome associated with short and thick filum terminale. Its treatable nature makes early diagnosis and timely surgical intervention important goals. The conus medullaris should not be located below the L2/L3 vertebral body in a neonate. Split cord malformation as a cause of tethered cord syndrome in a 78-year-old female. The thickened filum terminale may be fibrous or lipomatous. The cadaveric case presented describes plain ⦠Patients with tethered cord syndrome (TCS) rarely have symptomatic onset in adulthood. 2001. Case report: Here we report the case of a 6 year old male child who presented with rapidly progressive weakness of both the lower limbs without any obvious sensory loss or bladder/bowel dysfunction. 58, No. Recently, mutations in the KMT2D and KDM6A genes have been identified as the causative factors in most KS cases. Author information: (1)Spinal Research Laboratory, Griffith University, Brisbane, Queensland, Australia. 1982. 12. The radiology literature varies with a conus at the L2/3 disc or L3 level considered within the normal range. Presentation. Radiology Case. Tethered Cord Syndrome Pankaj K. Agarwalla, BS, Ian F. Dunn, MD, ... cases documenting the diagnosis and treatment of tethered cord syndrome, an 1857 report describes a young child who presented with worsening right-sided lower extremity weakness and twitch-ing [13]. Pediatr Neurosurg. Radiographic findings may include the conus medullaris in a lower than normal position, fatty infiltration of the filum terminale, lipomyelomeningocele, myelomeningocele, myelocystocele, meningocele, split cord malformations, dermal sinus, anorectal ⦠Patients with tethered cord syndrome (TCS) rarely have symptomatic onset in adulthood. Surg Radiol Anat. 1 Adult tethered cord syndrome in patients with postrepair myelomeningocele: an evidence-based outcome study Journal of Neurosurgery, Vol. Split spinal cord malformation in an elderly patient: Case report. Tethered spinal cord with filum terminale lipoma Other cases by these authors: Wolfgang Hirsch (17) . Because of present referral patterns, adult patients with tethered cord syndrome may present initially to ⦠In cases in which there is a low tethered cord, the conus is low and the spinal cord is displaced dorsally. 17 In order to determine the childâs bowel/bladder and lower extremity functional status, an evaluation by neurosurgery, ⦠In our case, child had Group 2 CRS with conus ending at L5 vertebral level and sacrum ending at S2 level. Diastematomyelia with tethered cord is an uncommon congenital anomaly that is generally diagnosed in childhood but may rarely present in adulthood, we present the case of a 48-year-old man with diastematomyelia and tethered cord whose diagnosis was initially missed, leading to unnecessary spine surgery. Diagnosis certain Diagnosis certain . Twenty-three adult patients with TCS were studied with respect to the clinical, radiological, and pathological features of this syndrome. Twenty-three adult patients with TCS were studied with respect to the clinical, radiological, and pathological features of this syndrome. To determine if the cord is low lying or potentially tethered its important to know what is the lowest level you can see a conus and still call it normal. Radiology. Aufschnaiter K, Fellner F, Wurm G (2008) Surgery in adult onset tethered cord syndrome (ATCS): review of literature on occasion of an exceptional case. Case report Management of tethered cord syndrome in adults: a case report in Cameroon Mathieu Motah 1 , Felix Uduma 2 , Aurélien Ndoumbe 1 , Mireille Georgette Moumi , Vincent de Paul Djientcheu 3. Evidence exists to suggest this can be a progressive neurological disorder due to growth and traction on abnormally positioned sacral roots, or in association with a tethered cord. 2 Lumbosacral lipoma causing tethering of the conus: Case ⦠From the manuscript Osteoid osteoma of the femur: masquerading the tethered cord syndrome. 1. Pre-operative examination findings included mild, global hypotonia and a coccygeal dimple without bladder or bowel abnormalities or spasticity. The primary tethered cord syndrome has been documented mainly in children and adolescents but also in adults, and ⦠Radiographic findings may include the conus medullaris in a lower than normal position, fatty infiltration of the filum terminale, lipomyelomeningocele, myelomeningocele, myelocystocele, meningocele, split cord malformations, dermal sinus, anorectal ⦠1991;13(4):339-43. Review of tethered cord syndrome with a radiological and anatomical study: case report. Quinones-Hinojosa A, Gadkary CA, Mummaneni PV, Rosenberg WS. The concept of the tethered cord has been around for over 150 years; however, ⦠It can occur because of congenital or acquired reasons and can lead to progressive neurological deficits. An abnormal cord may lie in a dorsal position rather than being dependent. Co-existing spinal intradural ependymal cyst and sacral Tarlov cyst in adult-onset tethered cord syndrome with syringomyelia: case report and literature review. 57: 32-47. In this study, we present three cases of KS associated with tethered cord syndrome. A five-month-old male presented with an incidentally found low-lying conus medullaris on ultrasound and subsequent MRI demonstrating its position at L4. igh (217) Spontaneous resolution of syringohydromyelia in a case of spinal Perimedullary Arteriovenous fistula (Type IVA) associated with low lying tethered cord Clin Case Rep Rev, 2017 doi: 10.15761/CCRR.1000340 Volume 3(5): 2-4 MRI scan of his spine revealed low lying tethered cord (lower Surg Neurol Int . 9,12â15 Although a tethered spinal cord is diagnosed by either a spinal ultrasound or MRI, only one-fifth of patients with tethered cord lesions will be symptomatic at presentation. Pang D, Wilberger JE Jr. Tethered cord syndrome in adults. 2016 ; 7 (25)(suppl 25) : S708 â S710 . Pathology. Myelomeningocele is known as a cause of tethered cord in 8% of cases 1. Less common pathologies include infectious, neoplastic, or traumatic origin. The patient underwent spinal cord untethering with a section ⦠In our case complex syndromes like VACTERL are excluded, because there is no evidence for cardiac pathology and anal stenosis. Case contributed by Dr Hidayatullah Hamidi. The association of syringohydromyelia with low lying tethered cord in a case of PMAVF with spontaneous resolution of the syrinx has not been previously described in literature. 1: Lymphangioleiomyomatosis 2: Angiomyolipomas of the kidney in Bourneville-Pringle's disease 3: Tuberous sclerosis of the brain / Bourneville-Pringle's disease 4: Osteoid osteoma of the tibia 5: Cystic fibrosis / Lung diagnostic with MRI 6: Congenital frontal sinus ⦠Hence, all tethered lesions should be excised to release the cord and dural stenosis should be treated by decompressive duroplasty. Journal of Radiology Case Reports Radiographically osteoid osteoma is visualized as a radiolucent ⦠The tethered spinal cord syndrome: a correlation of radiological features and peroperative findings in 30 patients. The tethered cord syndrome (TCS), also known as tight filum terminale syndrome is a clinical entity by which signs and symptoms are caused by excessive tension on the spinal cord.The majority of cases of tethered cord are related to spinal dysraphism. J Neurosurg. Merx JL, Bakker-Niezen SH, Thijssen HOM, and Walder HAD. 8, No. Lipomyelocele occurs most commonly in the lower lumbar and sacral region as in this case.
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