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Tethered cord syndrome
F Rinaldi1, F A Cioffi, L Columbano
1Department of Neuroradiology, Second University of Naples Medical School, Naples, Italy.
Journal of Neurosurgical Sciences
|December 24, 2005
Summary
Tethered cord syndrome (TCS) can manifest in adulthood with neurological deficits. Early diagnosis and surgical untethering are crucial for improving symptoms and preventing permanent disability.
Area of Science:
- Neurology
- Neurosurgery
- Pediatric Neurology
Background:
- Tethered cord syndrome (TCS) is a spinal cord disorder caused by inelastic structures, often a short filum terminale, anchoring the spinal cord.
- Associated conditions like spinal dysraphism, hydromielia, and Arnold-Chiari malformation can occur, but their etiological link to TCS requires further clarification.
Purpose of the Study:
- To analyze neuroradiological findings in pediatric and adult patients with TCS.
- To establish precise diagnostic criteria and therapeutic strategies, including conservative and surgical options.
Main Methods:
- Retrospective analysis of neuroradiological findings in 14 patients (5 children, 9 adults).
- Inclusion criteria: neurological disturbances at the conus medullaris level and evidence of spinal dysraphism.
- Diagnostic modalities included X-ray, CT, CT-myelography, and MRI, with MRI identified as the preferred method.
Main Results:
- TCS diagnosis typically occurs in childhood but can present insidiously in adulthood with symptoms like gait disturbances, muscle atrophy, sensory loss, and pain.
- MRI is the diagnostic method of choice.
- Surgical untethering is recommended and can improve pain, ambulation, and bladder function.
Conclusions:
- Sphincter dysfunction may persist even after surgery.
- Prophylactic surgery is advisable due to the risk of rapid deterioration and incomplete neurological recovery.
- Long-term follow-up is essential for patients, especially those not undergoing surgery.
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