Tethered cord in the adult mimicking the lumbar disc syndrome: Report of two cases

Gökay, H; Barlas, Orhan; Hepgül, Kemal; Hiçdönmez, Tufan

doi:10.1016/0090-3019(93)90028-y

Cited by 14 publications

(3 citation statements)

References 6 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[ 18 ] Although TCS is generally considered as a childhood disease, it could also occur in adults. [ 19 – 21 ] The symptoms of TCS vary, ranging from no symptoms to paraplegia. [ 22 , 23 ] Adult TCS is generally diagnosed when patients suffer back pain and/or lower limbs pain.…”

Section: Discussionmentioning

confidence: 99%

Spinal cord infarction caused by sacral canal epidural steroid injection

et al. 2018

View full text Add to dashboard Cite

Rationale:Spinal cord infarction is one of the complications of epidural steroid injections (ESIs), but has only been reported in cervical vertebra by transforaminal injection and lumbar vertebra by transforaminal injection; and up to now, there is no reporting about spinal cord infarction caused by caudal injection. Here, we report a case.Patient concerns:A 52-year-old man was admitted to our hospital. He was diagnosed as lumbar disc herniation in other hospital, and the patient suffered bilateral lower limb motor and sensory disorders after administration of caudal ESI.Diagnosis:Spinal cord infarction, tethered cord syndrome (TCS), and acute myelitis.Interventions:High doses of hormones, gamma globulin impact therapy, and rehabilitation were performed.Outcomes:The patient's condition was stable when he discharged from the hospital after 20 days of treatment. Discharge status: grade 0 of bilateral lower limbs muscle strength, inability to urinate and defecate by himself, slightly decreased touch, and needling sensation below the umbilical plane.Lessons:When patients are diagnosed with lumbar disc herniation and need to receive invasive treatments, magnetic resonance imaging (MRI) should be performed before the invasive procedures.

show abstract

Section: Discussionmentioning

confidence: 99%

Spinal cord infarction caused by sacral canal epidural steroid injection

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Presenting with similar symptoms, such as back and leg pain, especially adult clinical presentation patients with lumbar disc herniation group tethered cords can be confused with tethered cord. And therefore Lumbar MRI examinations should be well evaluated in the preoperative period 4) .…”

Section: Discussionmentioning

confidence: 99%

Lumbar Disc Herniation in a Patient With Congenital Vertebral Body Anomaly: A Case Report

et al. 2014

View full text Add to dashboard Cite

Lumbar disc herniation is characterized with low back and leg pain resulting from the degenerated lumbar disc compressing the spinal nerve root. The etiology of degenerative spine is related to age, smoking, microtrauma, obesity, disorders of familial collagen structure, occupational and sports-related physical activity. However, disc herniations induced by congenital lumbar vertebral anomalies are rarely seen. Vertebral fusion defect is one of the causes of congenital anomalies. The pathogenesis of embryological corpus vertebral fusion anomaly is not fully known. In this paper, a 30-year-old patient who had the complaints of low back and right leg pain after falling from a height is presented. She had right L5-S1 disc herniation that had developed on the basis of S1 vertebra corpus fusion anomaly in Lumbar computed tomography. This case has been discussed in the light of literature based on evaluations of Lumbar Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). This case is unique in that it is the first case with development of lumbar disc herniation associated with S1 vertebral corpus fusion anomaly. Congenital malformations with unusual clinical presentation after trauma should be evaluated through advanced radiological imaging techniques.

show abstract

“…Patients with signs and symptoms of a lumbar disc disease, for example, may only later turn out to suffer from a TCS. 6 A high index of suspicion on the surgeon's part should reduce this delay in the future. In addition to a delay in diagnosis, we found a mean delay in surgical treatment of 4 years, which may be caused by a reluctance of physicians to refer these patients to a neurosurgical clinic or by a reluctance on the part of the consulted neurosurgeon to perform surgery, both for fear of surgery-induced neurological deterioration.…”

Section: Preoperative Assessmentmentioning

confidence: 99%

Surgery in adults with tethered cord syndrome: outcome study with independent clinical review

Leeuwen¹,

Notermans²,

Vandertop³

2001

Journal of Neurosurgery: Spine

View full text Add to dashboard Cite

Object. The authors conducted a study to evaluate the risks and short-term benefits of surgical treatment for tethered cord syndrome (TCS) in patients older than 18 years of age. Methods. The authors studied a series of 57 consecutive adult patients with TCS of varying origins. Patients were examined by the same neurologist in a standardized fashion before and after surgery, and most were followed for at least 2 years postoperatively. Patient age ranged from 19 to 75 years. The mean age at onset of symptoms and diagnosis was 30 years and 37 years, respectively. Muscle strength improved (15 cases) or showed no change postoperatively (38 cases) in a large majority of patients (93%). In four patients a minor decrease in muscle strength was demonstrated, and there was significant deterioration in two (3.5%). In the two latter patients, a rapid decline in motor function was present preoperatively. Subjective assessment of pain, gait, sensory function, and bladder/bowel function at 4 weeks, 6 months, and 2 years postsurgery revealed improvement in a substantial percentage of patients. No major surgery-related complications occurred. Conclusions. This is the largest series to date in which adult patients with TCS comprise the report. Untethering procedures in these patients were safe and effective, at least in the short term. Patients with rapid loss of motor function, lipomyelomeningocele, or split cord malformation seem to be at a higher risk of postsurgery deterioration. A follow-up period of many more years will be necessary to determine whether aggressive surgery is beneficial in the long term.

show abstract

Tethered cord in the adult mimicking the lumbar disc syndrome: Report of two cases

Cited by 14 publications

References 6 publications

Spinal cord infarction caused by sacral canal epidural steroid injection

Spinal cord infarction caused by sacral canal epidural steroid injection

Lumbar Disc Herniation in a Patient With Congenital Vertebral Body Anomaly: A Case Report

Surgery in adults with tethered cord syndrome: outcome study with independent clinical review

Contact Info

Product

Resources

About