So-called tethered cervical spinal cord

Abstract

A case is reported of the so-called Tethered Cervical Spinal Cord Syndrome presenting as multiradicular pain on an upper limb in a 45-year old woman, in whom spina bifida occulta (C6) was associated with an intramedullary lipoma, intradural fibrous adhesions and the fusion of the sixth and seventh cervical vertebrae. Surgical release of the tether was ineffective, and the patient underwent a posterior rhizotomy for pain relief. The clinical and maldevelopmental aspects of this most uncommon form of spinal cord tethering are discussed briefly.

Tethered Cord Syndrome: An Updated Review

“…There are insufficient data available to predict outcome with surgery in these patients due to the scarcity of published cases. While most reports indicate improvement with untethering, this is not always the case[ 70]. …”

“…Many of the anomalies associated with TCS have been reported to cause cervical cord tethering: including lipomas[ 70, 71], myelomeningoceles[ 72], dermal sinus tracts[73,74,75], and split cord malformations[ 76, 77]. Upper extremity signs and symptoms may be present because of the more rostral involvement of the cord.…”

Pure tethered cervical cord and review of literature

“…Tethering of the spinal cord in the lumbosacral region with or without myelomeningocele is a well-known phenomenon. Tethering along the rest of the neuraxis, including the hindbrain,[ 1 ] cerebellar vermis,[ 2 ] medulla[ 3 ] cervical,[ 4 5 6 7 8 9 10 ] and thoracic[ 11 ] spinal cord have been documented. In literature, the tethered cervical cord is always associated with the various congenital malformations (hydrocephalus,[ 12 ] Chiari malformation, myelomeningocele, meningocele, hamartomatous stalk, spina bifida occulta, intramedullary lipoma, intradural fibrous adhesions, the fusion of the sixth and seventh cervical vertebrae, split cord malformation, or low-lying cord).…”

Tethered Spinal Cord: Review of Literature

“…These attachments cause an abnormal stretching of the spinal cord ( Figure 1). Only sporadic cases of tethering along the rest of the neuraxis, including the hindbrain, cervical, and thoracic spinal cord have been documented, always along with some associated congenital malformations (hydrocephalus, Chiari malformation, myelomeningocele, meningocele, hamartomatous stalk, spina bifida occulta, intramedullary lipoma, intradural fibrous adhesions, the fusion of the sixth and seventh cervical vertebrae, split cord malformation, or low-lying cord) [1][2][3][4][5][6][7][8][9][10][11] . It is estimated that 20% -50% of children with spina bifida defects repaired shortly after birth will require surgery at some point to untether the spinal cord.…”