Minimally invasive endoscopic spinal cord untethering: case report.
Albert Edward Telfeian, Michael Punsoni, Christoph P Hofstetter1
1Department of Neurosurgery, University of Washington, Seattle, WA, USA.
Journal of Spine Surgery (Hong Kong)
|July 27, 2017
Summary
Tethered cord syndrome, often caused by spinal dysraphism, can be effectively treated with minimally invasive endoscopic surgery. This approach offers potential benefits like reduced pain and scarring for patients with conditions like lipomyelomeningocele.
Area of Science:
- Neurosurgery
- Minimally Invasive Spine Surgery
Background:
- Tethered cord syndrome (TCS) encompasses neurological deficits including back/leg pain, bowel/bladder dysfunction, and limb deformities.
- TCS can result from a tight filum terminale or spinal dysraphism, such as lipomyelomeningocele.
Observation:
- A 40-year-old male presented with back pain, bilateral radicular pain, and bowel/bladder dysfunction.
- MRI revealed a sacral lipomyelomeningocele with the conus medullaris tethered at L4-L5 by superiorly extending fat.
Findings:
- A minimally invasive endoscopic approach was utilized for surgical release.
- The procedure successfully identified and transected the filum terminale through a small dural opening, with an uneventful postoperative course.
Implications:
- Minimally invasive spine techniques, particularly endoscopic approaches, offer advantages in TCS treatment, potentially reducing pain, spinal fluid leakage, and scarring.
- Endoscopic visualization and techniques are advancing, providing minimally invasive adjuncts to traditional surgical methods for various spinal pathologies.
