Tethered spinal cord following repair of myelomeningocele.

Abstract:

OBJECT:The goal of this paper is to elucidate the clinical presentation of tethered cord syndrome (TCS) following repair of a myelomeningocele. METHODS:Approximately 10 to 30% of children will develop TCS following repair of a myelomeningocele. Because essentially all children with repaired myelomeningocele will have a tethered spinal cord, as demonstrated on MR imaging, the diagnosis of TCS is made based on clinical criteria. The six common clinical presentations of TCS are increased weakness (55%), worsening gait (54%), scoliosis (51%), pain (32%), orthopedic deformity (11%), and urological dysfunction (6%). The primary goal of surgery is to detach the spinal cord where it is adherent to the thecal sac, relieving the stretch on the terminal portion of the cord. CONCLUSIONS:Early diagnosis and surgical release of the tethered cord results in stabilization or improvement in most cases. Because TCS may present with orthopedic and/or urological signs or symptoms, children with myelomeningocele should by followed, ideally in a multidisciplinary clinic, by neurosurgeons, orthopedic surgeons, and urologists who are aware of this condition.

journal_name

Neurosurg Focus

journal_title

Neurosurgical focus

authors

Hudgins RJ,Gilreath CL

doi

10.3171/foc.2004.16.2.8

subject

Has Abstract

pub_date

2004-02-15 00:00:00

pages

E7

issue

2

issn

1092-0684

pii

160207

journal_volume

16

pub_type

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