Pathophysiology of adult tethered cord syndrome: review of the literature.

Abstract:

OBJECT:Tethering of the spinal cord has been a recognized cause of neurological symptoms in pediatric patients and is increasingly being recognized as a cause of symptoms in adults as well. The pathophysiology surrounding spinal cord tethering has begun to be understood in the pediatric population but is still unclear in adult patients. METHODS:Using a PubMed database literature search, the authors reviewed the pathology and pathophysiology surrounding the tethered spinal cord, focusing particularly on the pathophysiology of adult tethered cord syndrome (TCS). RESULTS:Experimental data obtained in pediatric patients at surgery and in animal models indicate that spinal cord tethering causes a reduction in spinal cord blood flow and dysfunction of neuronal mitochondrial terminal oxidase. Retrospective analyses of patients undergoing surgery for adult TCS show that many adults developed symptoms following an event that could stretch the spinal cord, while others did not. Many patients also were found to have structural lesions in addition to a tethered spinal cord at diagnosis. CONCLUSIONS:Both adult and pediatric TCSs are likely the result of a relative lack of blood flow to the spinal cord, causing dysfunction in mitochondrial oxidative phosphorylation. The likely reason the syndrome present later and differently in adults is that a secondary threshold of tension or a cumulative effect of repetitive, transient tension is placed on the cord before symptoms are recognized.

journal_name

Neurosurg Focus

journal_title

Neurosurgical focus

authors

Stetler WR Jr,Park P,Sullivan S

doi

10.3171/2010.3.FOCUS1080

subject

Has Abstract

pub_date

2010-07-01 00:00:00

pages

E2

issue

1

issn

1092-0684

journal_volume

29

pub_type

杂志文章,评审
  • The axial transsacral approach to interbody fusion at L5-S1.

    abstract::Lumbosacral interbody fusion may be indicated to treat degenerative disc disease at L5-S1, instability or spondylolisthesis at that level, and severe neural foraminal stenosis resulting from loss of disc space height. In addition, L5-S1 interbody fusion may provide anterior support to a long posterior fusion construct...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2014.2.FOCUS13467

    authors: Issack PS,Kotwal SY,Boachie-Adjei O

    更新日期:2014-05-01 00:00:00

  • A novel percutaneous system for bone graft delivery and containment for elevation and stabilization of vertebral compression fractures. Technical note.

    abstract:OBJECT:Vertebroplasty and kyphoplasty are minimally invasive procedures used to treat persistently symptomatic vertebral compression fractures (VCFs). Both interventions usually involve injection of polymethyl methacrylate (PMMA). The purpose of this technical note was to review the theory and surgical technique for a ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2005.18.3.11

    authors: Lam S,Khoo LT

    更新日期:2005-03-15 00:00:00

  • Minimal tethered cord syndrome: what's necessary to justify a new surgical indication?

    abstract::Traditionally, surgical division of the terminal filum (filum terminale) has been reserved for patients with imaging-apparent spinal cord tethering. The occurrence of medically refractory voiding dysfunction of neurogenic origin, without magnetic resonance (MR) imaging documentation of abnormality in the spine, has be...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/FOC-07/08/E1

    authors: Selden NR

    更新日期:2007-01-01 00:00:00

  • Growing up with spina bifida: bridging the gaps in the transition of care from childhood to adulthood.

    abstract::Spina bifida is the most common nonchromosomal birth defect, resulting in permanent disability of multiple organ systems, yet compatible with long-term survival. Important advances across various disciplines have now improved survival among the spina bifida population. Although the majority of individuals living with ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2019.7.FOCUS19441

    authors: Patel SK,Staarmann B,Heilman A,Mains A,Woodward J,Bierbrauer KS

    更新日期:2019-10-01 00:00:00

  • Outpatient spine surgery: defining the outcomes, value, and barriers to implementation.

    abstract::Spine surgery is a key target for cost reduction within the United States health care system. One possible strategy involves the transition of inpatient surgeries to the ambulatory setting. Lumbar laminectomy with or without discectomy, lumbar fusion, anterior cervical discectomy and fusion, and cervical disc arthropl...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2018.2.FOCUS17790

    authors: Pendharkar AV,Shahin MN,Ho AL,Sussman ES,Purger DA,Veeravagu A,Ratliff JK,Desai AM

    更新日期:2018-05-01 00:00:00

  • Effect of intraarterial papaverine and/or angioplasty on the cerebral veins in patients with vasospasm after subarachnoid hemorrhage due to ruptured intracranial aneurysms.

    abstract:OBJECT:The goal in this study was to determine if there was a change in intracranial venous diameters after endovascular treatment of carotid distribution vasospasm caused by subarachnoid hemorrhage. METHODS:The venous diameters were measured in all patients who received intraarterial papaverine and/or balloon angiopl...

    journal_title:Neurosurgical focus

    pub_type: 临床试验,杂志文章

    doi:10.3171/foc.2006.21.3.16

    authors: Elsayed AA,Moran CJ,Cross DT 3rd,Derdeyn CP,Pilgram TK,Milburn JM,Dacey RG Jr,Diringer MN Jr

    更新日期:2006-09-15 00:00:00

  • Deep brain stimulation for the treatment of drug-refractory epilepsy in a patient with a hypothalamic hamartoma. Case report.

    abstract::Hypothalamic hamartomas (HHs) are developmental malformations associated with a range of neurological problems, including intractable seizures. There is increasing evidence of the epileptogenicity of the hamartoma and of the inhomogeneous distribution of the epileptic abnormalities within the malformation. The managem...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2010.11.FOCUS10241

    authors: Marras CE,Rizzi M,Villani F,Messina G,Deleo F,Cordella R,Franzini A

    更新日期:2011-02-01 00:00:00

  • Combined interhemispheric translamina terminalis and pterional approach for a dorsum sellae meningioma.

    abstract::This video demonstrates a surgical technique of resecting dorsum sellae meningioma using a combined interhemispheric translamina terminalis approach and pterional approach with clinoidectomy. The tumor, 5 cm in maximum diameter, originated from the dorsum sellae, compressed the third ventricle and the midbrain, and di...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2017.10.FocusVid.17302

    authors: Suematsu S,Ono H,Inoue T,Tamura A

    更新日期:2017-10-01 00:00:00

  • Update on flow diverters for the endovascular management of cerebral aneurysms.

    abstract::Flow diversion has become a well-accepted option for the treatment of cerebral aneurysms. Given the significant treatment effect of flow diverters, numerous options have emerged since the initial Pipeline embolization device studies. In this review, the authors describe the available flow diverters, both endoluminal a...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2017.3.FOCUS16427

    authors: Rajah G,Narayanan S,Rangel-Castilla L

    更新日期:2017-06-01 00:00:00

  • Contralateral C-7 transfer: is direct repair really superior to grafting?

    abstract::It is not uncommon for a severe traumatic brachial plexus injury to involve all 5 roots, resulting in a flail upper limb. In such cases, surgical reconstruction is often palliative, providing only rudimentary function. Nerve transfers are the mainstay of reconstructive strategies due to the predominance of root avulsi...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2017.4.FOCUS1794

    authors: Bhatia A,Doshi P,Koul A,Shah V,Brown JM,Salama M

    更新日期:2017-07-01 00:00:00

  • The endoscopic transoral approach to the craniovertebral junction: an anatomical study with a clinical example.

    abstract::OBJECTIVE The microscopic transoral, endoscopic transnasal, and endoscopic transoral approaches are used alone and in combination for a variety of craniovertebral junction (CVJ) pathologies. The endoscopic transoral approach provides a more direct exposure that is not restricted by the nasal cavity, pterygoid plates, ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2015.11.FOCUS15498

    authors: Chan AK,Benet A,Ohya J,Zhang X,Vogel TD,Flis DW,El-Sayed IH,Mummaneni PV

    更新日期:2016-02-01 00:00:00

  • The role of electrodiagnostic testing in carpal tunnel syndrome.

    abstract::Electrodiagnostic testing in patients who have upper-extremity symptoms, which may include carpal tunnel syndrome (CTS), has been the gold standard for diagnosis for many years. Despite their value, these tests are underutilized. The authors examined the use patterns of electrodiagnostic testing at the University of V...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.1997.3.1.5

    authors: Phillips LH 2nd,Juel VC

    更新日期:1997-07-15 00:00:00

  • Quality of life following acoustic neuroma surgery.

    abstract::In the treatment of acoustic neuroma, operative results have improved greatly during recent years, with high rates of functional cranial nerve preservation. Because of this, it has become more important to consider issues of patient satisfaction and quality of life (QOL) following treatment for these lesions. The auth...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:

    authors: Schwartz MS,Riddle SA,Delashaw JB Jr,Horgan MA,Kellogg JX,McMenomey SO

    更新日期:1998-09-15 00:00:00

  • Mini-open transforaminal lumbar interbody fusion.

    abstract::The potential advantages of a mini-open transforaminal interbody fusion (TLIF) operation are reduced blood loss, shorter length of stay, and less soft-tissue trauma compared to the standard open technique. Prior reports from our group and others have demonstrated successful outcomes using MIS techniques in lumbar fusi...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2013.V2.FOCUS13187

    authors: Amin BY,Tu TH,Mummaneni PV

    更新日期:2013-07-01 00:00:00

  • Deep brain stimulation for hyperkinetic disorders.

    abstract::Deep brain stimulation (DBS) has a record of safety and efficacy for an expanding range of indications. Recently,the Food and Drug Administration provided approval through a Humanitarian Device Exemption for DBS of the globus pallidus internus and subthalamic nucleus for the treatment of dystonia. There is increasing ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/foc.2004.17.1.1

    authors: Montgomery EB Jr

    更新日期:2004-07-15 00:00:00

  • Craniofacial reconstruction with a fast resorbing polymer: a 6- to 12-month clinical follow-up review.

    abstract:OBJECT:Resorbable polymer implants have become a compelling option in the treatment of acquired and congenital craniofacial deformities. In particular, the resorbable polylactide and polyglycolide polymers have demonstrated excellent safety profiles in multiple in vitro, animal, and clinical studies and are currently b...

    journal_title:Neurosurgical focus

    pub_type: 临床试验,杂志文章

    doi:10.3171/foc.2004.16.3.13

    authors: Cohen SR,Holmes RE,Meltzer HS,Levy ML,Beckett MZ

    更新日期:2004-03-15 00:00:00

  • Dural relationships of Meckel cave and lateral wall of the cavernous sinus.

    abstract:OBJECT:The purpose of this study was to elucidate the anatomy of the trigeminal nerve (cranial nerve [CN] V), Meckel cave (MC), and lateral wall of the cavernous sinus (CS). METHODS:Ten fresh cadaver heads (20 sides) and 2 middle fossa embalmed specimens were removed, decalcified, sectioned, stained, and studied micro...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/FOC.2008.25.12.E2

    authors: Janjua RM,Al-Mefty O,Densler DW,Shields CB

    更新日期:2008-01-01 00:00:00

  • Multimodal navigation in the functional microsurgical resection of intrinsic brain tumors located in eloquent motor areas: role of tractography.

    abstract:OBJECT:Nowadays the role of microsurgical management of intrinsic brain tumors is to maximize the volumetric resection of the tumoral tissue, minimizing the postoperative morbidity. The purpose of this paper was to study the benefits of an original protocol developed for the microsurgical treatment of tumors located in...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2009.11.FOCUS09234

    authors: González-Darder JM,González-López P,Talamantes F,Quilis V,Cortés V,García-March G,Roldán P

    更新日期:2010-02-01 00:00:00

  • In vivo visualization of GL261-luc2 mouse glioma cells by use of Alexa Fluor-labeled TRP-2 antibodies.

    abstract:OBJECT:For patients with glioblastoma multiforme, median survival time is approximately 14 months. Longer progression-free and overall survival times correlate with gross-total resection of tumor. The ability to identify tumor cells intraoperatively could result in an increased percentage of tumor resected and thus inc...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2013.12.FOCUS13488

    authors: Fenton KE,Martirosyan NL,Abdelwahab MG,Coons SW,Preul MC,Scheck AC

    更新日期:2014-02-01 00:00:00

  • Prevalence of cervical spinal injury in trauma.

    abstract:OBJECT:Diagnosis of cervical spinal injury (CSI) is an essential aspect of the trauma evaluation. This task is especially difficult in patients who are not clinically able to be evaluated (unevaluable) because of distracting painful injuries, intoxication, or concomitant head injury. For this population, the appropriat...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/FOC.2008.25.11.E10

    authors: Milby AH,Halpern CH,Guo W,Stein SC

    更新日期:2008-01-01 00:00:00

  • Prognosis in patients presenting with brain metastasis from an undiagnosed primary tumor.

    abstract:OBJECT:The aim of this study was to test the validity of the hypothesis that patients in whom brain metastasis is the first indication of an undiagnosed primary tumor have a better chance of survival than similar patients with a known primary lesion. METHODS:Between January 1983 and December 1998, 342 patients with co...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.2007.22.3.8

    authors: D'Ambrosio AL,Agazzi S

    更新日期:2007-03-15 00:00:00

  • An ancestor of the stereotactic atlases: the Tabulae Anatomicae of Bartolomeo Eustachio.

    abstract::The authors report the history of the Tabulae Anatomicae of Bartolomeo Eustachio (ca. 1510-1574). In the tables, the anatomical illustrations were drawn inside a numerical frame, with pairs of numbers on the y- and x-axes to identify single anatomical details in the reference table. The measures and the references cou...

    journal_title:Neurosurgical focus

    pub_type: 传,历史文章,杂志文章

    doi:10.3171/2019.6.FOCUS19339

    authors: Dario A,Armocida GO,Locatelli D

    更新日期:2019-09-01 00:00:00

  • The case for a comparative, value-based alternative to the patient-centered outcomes research model for comparative effectiveness research.

    abstract::Considerable financial and human resources have been directed toward the emerging field of comparative effectiveness research (CER) in the US. Fundamentally, the concept of CER is so logical as to be almost self-evident; namely, that research regarding therapeutic strategies should go beyond efficacy and examine objec...

    journal_title:Neurosurgical focus

    pub_type: 社论

    doi:10.3171/2012.5.FOCUS12127

    authors: Marko NF,Weil RJ

    更新日期:2012-07-01 00:00:00

  • Expanding indications for the extended endoscopic endonasal approach to hypothalamic gliomas: preliminary report.

    abstract::Object In the last decade the indications for the endoscopic endonasal approach have been progressively expanded to include lesions that have not been traditionally considered amenable to resection through the transsphenoidal route. In this study, the authors analyze their experience with hypothalamic gliomas treated ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2014.7.FOCUS14317

    authors: Zoli M,Mazzatenta D,Valluzzi A,Marucci G,Acciarri N,Pasquini E,Frank G

    更新日期:2014-01-01 00:00:00

  • Comprehensive approach to Chiari malformation in pediatric patients.

    abstract::Chiari malformation is a developmental disorder that is often associated with other abnormalities of the cerebrospinal axis. Despite widespread recognition of this association, there is relatively little information on the treatment of these coexisting disorders in the setting of cerebellar tonsillar ectopia. In an ef...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.1999.6.6.5

    authors: Greenlee J,Garell PC,Stence N,Menezes AH

    更新日期:1999-06-15 00:00:00

  • Decision making for the surgical approach of posterior petrous bone meningiomas.

    abstract:OBJECT:The authors undertook this study to examine the surgical approaches used to treat posterior petrous bone meningiomas at a single institution and retrospectively evaluate their surgical strategy based on a previously published classification. METHODS:Cases in which craniotomies were performed to treat posterior ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2011.2.FOCUS1119

    authors: Roche PH,Lubrano V,Noudel R,Melot A,Régis J

    更新日期:2011-05-01 00:00:00

  • Microsurgical resection of intramedullary spinal cord cavernous malformation. Operative video and technical nuances.

    abstract::Intramedullary spinal cord cavernous malformations account for approximately 5% of all intraspinal lesions. These lesions can present with either acute neurological compromise secondary to hemorrhage inside the spinal cord, or with chronic progressive myelopathy due to repeated microhemorrhages. Surgical resection of ...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2014.V3.FOCUS14155

    authors: Liu JK

    更新日期:2014-09-01 00:00:00

  • Facial paralysis caused by malignant skull base neoplasms.

    abstract:OBJECT:Bell palsy remains the most common cause of facial paralysis. Unfortunately, this term is often erroneously applied to all cases of facial paralysis. METHODS:The authors performed a retrospective review of data obtained in 11 patients who were treated at a university-based referral practice between July 1988 an...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/foc.2002.12.5.3

    authors: Marzo SJ,Leonetti JP,Petruzzelli G

    更新日期:2002-05-15 00:00:00

  • Determination of geographic variance in stroke prevalence using Internet search engine analytics.

    abstract:OBJECT:Previous methods to determine stroke prevalence, such as nationwide surveys, are labor-intensive endeavors. Recent advances in search engine query analytics have led to a new metric for disease surveillance to evaluate symptomatic phenomenon, such as influenza. The authors hypothesized that the use of search eng...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章

    doi:10.3171/2011.2.FOCUS1124

    authors: Walcott BP,Nahed BV,Kahle KT,Redjal N,Coumans JV

    更新日期:2011-06-01 00:00:00

  • Surgical approaches for resection of vestibular schwannomas: translabyrinthine, retrosigmoid, and middle fossa approaches.

    abstract::Surgical removal remains one of the key treatment modalities for vestibular schwannomas. A team approach between a neurotologist and a neurosurgeon offers the patient the expertise of both specialties and maximizes the chances for an optimal outcome. Vestibular schwannomas can typically be resected through 1 of 3 main...

    journal_title:Neurosurgical focus

    pub_type: 杂志文章,评审

    doi:10.3171/2012.6.FOCUS12190

    authors: Chamoun R,MacDonald J,Shelton C,Couldwell WT

    更新日期:2012-09-01 00:00:00