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Tethered cord syndrome: a pediatric case study
1Neurological Institute, New York, NY 10032.
Insights
Tethered cord syndrome causes progressive neurological decline in patients with spinal dysraphism due to spinal cord stretching. This condition involves a low conus medullaris tethered by various intradural abnormalities.
Area of Science:
- Neurology
- Developmental Biology
- Pediatric Neurosurgery
Background:
- Spinal dysraphism arises from embryonic neural tube closure defects, primarily in the lumbosacral area.
- Tethered cord syndrome (TCS) is a consequence of spinal dysraphism, characterized by progressive neurological deterioration.
- TCS results from the spinal cord being abnormally stretched due to various intradural abnormalities.
Observation:
- The conus medullaris is abnormally low in patients with TCS.
- Intradural abnormalities causing tethering include a short, thickened filum terminale, fibrous bands, lipomas, and diastematomyelia.
- This article differentiates TCS from other forms of occult spinal dysraphism.
Findings:
- Pathological changes in TCS involve the abnormal tethering of a low-lying spinal cord.
- Comparison of normal anatomy with pathological changes in the spinal cord is presented.
- Clinical symptoms and nursing management are detailed through a pediatric case study.
Implications:
- Understanding TCS is crucial for accurate diagnosis and management of spinal dysraphism.
- Differentiating TCS from other occult spinal dysraphic conditions aids in appropriate treatment planning.
- The case study provides practical insights into the clinical presentation and nursing care of pediatric TCS patients.
Abstract:
Tethered cord syndrome, seen in patients with spinal dysraphism, is a progressive neurological deterioration due to stretching of the spinal cord. Spinal dysraphism results from defects during embryonic closure of the neural tube, usually in the lumbosacral region. In tethered cord syndrome an abnormally low conus medullaris is tethered by intradural abnormalities such as a short, thickened filum terminale, fibrous bands, a lipoma or diastematomyelia. This article distinguishes tethered cord syndrome from other forms of occult spinal dysraphism and describes and compares normal anatomy to pathological changes. Clinical symptoms and nursing management of the pediatric patient with tethered cord syndrome will be exemplified by a case study presentation.