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Anterior cervical spinal cord tethering after anterior spinal surgery: case report
David J Hart1, Ronald I Apfelbaum
1Department of Neurological Surgery, Los Angeles County and University of Southern California, Los Angeles, California, USA. david.hart@uhhs.com
Objective And Importance:
This is the first reported case of anterior cervical spinal cord tethering after anterior spinal surgery. A mechanistic hypothesis is presented to explain the observed phenomenon.
Clinical Presentation:
A patient developed cervical myelopathy 2 years after multiple anterior cervical discectomies complicated by cerebrospinal fluid leakage. She demonstrated reflex and motor changes as well as neuropathic pain.
Intervention:
An anterior corpectomy was performed, with opening of the dura and detethering of an arachnoid band and then fusion and plating.
Conclusion:
Reflex and motor changes improved, but pain did not. We hypothesize that mechanical deformation and scar formation after cerebrospinal fluid leakage may have led to tethering of the spinal cord.