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Related Concept Videos

The Spinal Cord01:54

The Spinal Cord

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The spinal cord is the body’s major nerve tract of the central nervous system, communicating afferent sensory information from the periphery to the brain and efferent motor information from the brain to the body. The human spinal cord extends from the hole at the base of the skull, or foramen magnum, to the level of the first or second lumbar vertebra.
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Spinal cord detethering without laminectomy or laminotomy.

Steven B Housley1, Devan Patel2, Elizabeth Nyabuto1

  • 1Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, Buffalo, New York, United States.

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Tethered cord syndrome, a condition of abnormal spinal cord tension, can cause neurological deficits. Minimally invasive detethering surgery offers a safe and effective treatment option for infants, potentially improving outcomes.

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DetetheringFilum terminalePediatricTethered cord

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Area of Science:

  • Neurology
  • Pediatric Surgery
  • Spinal Cord Medicine

Background:

  • Tethered cord syndrome (TCS) involves abnormal tension on the distal spinal cord, leading to neural and microvascular stretching and injury.
  • Associated conditions include myelomeningocele, lipomas, and trauma; symptoms range from weakness and sensory deficits to bowel/bladder dysfunction and pain.
  • Early surgical intervention, particularly before age 2, is linked to improved outcomes in TCS patients.

Observation:

  • A 6-month-old male presented with a low-lying conus medullaris, lumbar syrinx, and asymmetric lower extremity utilization.
  • The patient exhibited mildly abnormal urodynamic studies.
  • Evaluation of a Y-shaped gluteal cleft revealed the underlying condition.

Findings:

  • The patient underwent successful, minimally invasive spinal cord detethering.
  • The surgical technique aimed for sufficient cord release without compromising the developing spinal column.
  • The procedure was safe and effective for this pediatric case.

Implications:

  • This case highlights the benefits of early surgical intervention for tethered cord syndrome.
  • The minimally invasive technique presented may guide surgeons in preserving spinal column integrity during detethering.
  • Further research into optimal surgical approaches for pediatric TCS is warranted.