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[The tethered cord syndrome : a review of causes]
1Servicio de Neurocirugía, Hospital de la Santa Creu i Sant Pau, Universidad Autónoma de Barcelona.
Insights
Tethered cord syndrome (TCS) affects adults and children, often presenting insidiously. Surgical intervention can improve or halt symptom progression, especially when diagnosed early.
Area of Science:
- Neurology
- Neurosurgery
- Pediatric Surgery
Background:
- Tethered cord syndrome (TCS) is a complex neurological condition.
- It often results from congenital spinal abnormalities or prior surgeries.
- Early diagnosis and intervention are crucial for managing TCS.
Purpose of the Study:
- To present a case series of patients with Tethered cord syndrome (TCS).
- To analyze clinical findings, diagnostic methods, and treatment outcomes.
- To evaluate prognostic factors influencing patient recovery.
Main Methods:
- Retrospective review of eighteen patients diagnosed with TCS.
- Analysis of clinical presentations, including neurological, skeletal, urological, and cutaneous findings.
- Evaluation of diagnostic modalities, primarily Magnetic Resonance Imaging (MRI) and urodynamic studies.
- Assessment of surgical outcomes and correlation with symptom duration.
Main Results:
- Eighteen cases of TCS were analyzed, including adults and children.
- Insidious onset was observed in 88% of cases; acute onset occurred in 12%.
- MRI was the primary diagnostic tool; urodynamic studies aided in managing urological issues.
- Post-surgical improvement or stabilization of symptoms occurred in 88% of patients.
- Shorter symptom duration (less than 2 years) correlated with a better prognosis.
Conclusions:
- Tethered cord syndrome requires a multidisciplinary approach for diagnosis and management.
- Prompt surgical intervention following accurate diagnosis can lead to favorable outcomes.
- Timely treatment is essential to prevent irreversible neurological damage and improve quality of life.
Abstract:
We present eighteen cases with Tethered cord syndrome (TCS). They were eleven adults and eight children. There were eight cases with surgical interventions performed in other centers during the newborn period for different types of spinal disraphisms. Clinical onset was insidious in 88% of the cases, and in 12% of the cases was acute, due to a precipitating factor. The main clinical findings were neurological skeletal , urological and cutaneous alterations in variable frequencies. Magnetic resonance imaging (MRI) was the best diagnostic test. Urodynamic studies in patients with urological alterations were abnormal and they helped to establish additional pharmacological treatment. After surgery 88% of the patients had an improvement or an arrest in the progression of the symptoms. Patients with shorter duration of the symptoms (less than 2 years) had a better prognosis.