Spinal Cord Disease
Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw in Hankey's Clinical Neurology, 2020
Structural spinal cord abnormality: Arnold–Chiari malformation with or without syringomyelia.Cervical or lumbar spondylosis.Tethered cord syndrome.Tumor of the spinal cord.AVM of the spinal cord.Granuloma (e.g. tuberculous) involving vertebrae and spinal cord.
Tethered Cord Syndrome
Jacques Corcos, Gilles Karsenty, Thomas Kessler, David Ginsberg in Essentials of the Adult Neurogenic Bladder, 2020
Tethered cord syndrome (TCS) is a functional disorder of the spinal cord caused by pathologic anchoring of its caudal end, causing neurologic dysfunction.1 While there was originally disagreement within the neurosurgical community regarding the existence of TCS as a separate entity from other neurologic conditions, it is now recognized as a distinct disorder. Despite being a distinct pathologic condition with its own clinical manifestations, TCS has been observed to need subsequent treatment in 20%–50% of children with spina bifida, highlighting the interrelated nature of lumbar cord disorders.2
Tethered cord syndrome
Jacques Corcos, David Ginsberg, Gilles Karsenty in Textbook of the Neurogenic Bladder, 2015
Tethered cord syndrome (TCS) is a stretch-induced functional disorder of the spinal cord caused by the anchoring of its caudal end by an inelastic structure. The neurologic dysfunction with TCS can be attributed to lumbosacral cord lesions and is reversible if cord-untethering surgery is done at an appropriate time. Clinical and basic research has indicated that oxidative metabolism is impaired in the tethered spinal cord and that there is a link between recovery from the neurologic dysfunction and oxidative metabolism when the stretched cord is released.1
Effect of untethering on occult tethered cord syndrome: a systematic review
Published in British Journal of Neurosurgery, 2022
Hamid Rezaee, Ehsan Keykhosravi
Tethered cord syndrome (TCS) is defined as a stretch-induced functional disorder of the spinal cord in which the caudal part of the spine is anchored by a deformed structure. It is associated with various underlying conditions, including open and closed forms of spinal dysraphism and more subtle structural abnormalities.1 Voiding dysfunction, lower-extremity weakness, progressive motor and sensory changes in the legs, back and leg pain, gait disturbance, orthopedic foot deformities, and scoliosis and/or urinary dysfunction are the main symptoms of TCS. The TCS appears in various forms, including tight filum terminale, lipomeningomyelocele, split cord malformations (diastematomyelia), dermal sinus tracts, and dermoids.2 Lumbosacral TCS is treated by surgical untethering via the section of the filum terminale (SFT).3
Absent sural responses in tethered cord syndrome
Published in The Journal of Spinal Cord Medicine, 2021
Elia G. Malek, Johnny Salameh, Nour Estaitieh, Achraf Makki
Tethered cord syndrome (TCS) is a progressive spinal cord disorder caused by stretch-induced dysfunction of the conus medullaris. Clinical signs and symptoms of TCS may be cutaneous, neurologic, musculoskeletal, and/or genitourinary.1 Toddlers and adolescents tend to present with gait or running difficulties due to progressive motor dysfunction, sensory deficits, progression of scoliosis, or development of orthopedic foot deformities.2 TCS may be associated with myelomeningocele, syringomyelia, diastematomyelia, dermoid sinus and intra or extradural lipoma which may exacerbate the clinical findings.3 Spine MRI demonstrates elongation and caudal descent of the conus medullaris (below L2 vertebral level) and a fatty filum terminale (usually >3 mm in diameter).4 While electrophysiological evaluation for patients with TCS was just limited to intraoperative monitoring, few studies performed a detailed electrophysiological assessment in non-operated patients.5,6 We report two pediatric cases with asymmetrically absent sural nerve response prior to their diagnosis of TCS.
Congenital Spinal Lipomatous Malformations. Part 2. Differentiation from Selected Closed Spinal Malformations
Published in Fetal and Pediatric Pathology, 2021
Roy H. Rhodes*
A medullary spinal cord may present with the tethered spinal cord syndrome that classically includes back pain, leg pain, lower extremity weakness, and urological symptoms [15, 16]. Intradural sacral spinal lipomas have been identified causing tethering of retained medullary cords. Other associated lesions include meningoceles, a lumbar nonterminal myelocystocele, diastematomyelia (a closed neural tube defect), an arteriovenous vascular malformation within the medullary cord, and the Currarino syndrome [11, 12].
Related Knowledge Centers
- Dermoid Cyst
- Diastematomyelia
- Filum Terminale
- Scoliosis
- Spinal Cord
- Lesion
- Neurology
- Lipomeningomyelocele
- Congenital Dermal Sinus
- Spina Bifida