Tethering of the conus medullaris within the sacrum.

Spinal dysraphism entirely confined to the cervical or dorsal levels is uncommon. In a large series affecting all levels, only 26 such cases that required operation were found. These are described in order to determine their particular features which include a high incidence of expanding lesions (dermoid cyst and neurenteric cyst) and are therefore associated with a much higher risk of morbidity than dysraphism at lower levels.

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“…These usually stress the need for early diagnosis and operative treatment to arrest or prevent neurological deterioration [4,7,9,11,17].…”

Section: Discussionmentioning

confidence: 99%

Spinal Dysraphism in the Cervical and Dorsal Regions in Childhood

Schiffer

Till

1982

Pediatr Neurosurg

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“…However, here no fatty tissue was detected, and also no enhancement was seen in the gadolinium enhanced images. In the present case, fibrous adhesion was considered to be the most probable cause (9,13). A tubular formation in the region of the conus medullaris seen on the Tl-weighted image was thought to be…”

Section: Discussionmentioning

confidence: 97%

Tethered Cord Syndrome Accompanied by Unilateral Muscle Atrophy in the Calf Muscle.

et al. 1994

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A 40-year-old man developed slowly progressive muscle atrophy in his calf muscle. The patient became aware of asymmetry of his right big toe during in his teens; muscle atrophy was revealed at the age of 25 years. Multi-image examinations revealed "tethered cord syndrome" with spina bifida occulta. Spinal magnetic resonance image revealed a pathogenetic mechanismof asymmetry of muscle atrophy in the calf muscle. This suggested that spinal MRIimaging is one of the most useful diagnostic methods for this disease.

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“…910 - 34 The absence or the existence of spinal pathway involvement thus reflects the extent and severity of the cord damage and parallel electrophysiological monitoring may be useful, alongside the clinical examination, to identify the nervous dysfunction as early as possible.…”

Section: -25mentioning

confidence: 99%

Spinal Somatosensory Evoked Potentials in Patients with Tethered Cord Syndrome

Polo

Zanette

Manganotti

et al. 1994

Can. j. neurol. sci.

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Abstract:We studied the electrophysiological changes occurring in six patients with tethered cord syndrome. Evidence of spinal malformations was provided by magnetic resonance imaging. The functional assessment of the spinal cord was performed by analysing both spinal and cortical somatosensory evoked potentials. The evoked electrospinogram was recorded from the thoracic and lumbosacral spinous processes. The N22 lumbosacral potential was selectively affected, being rostrocaudally displaced and reduced in amplitude or even absent in patients with neurological signs indicating a segmental lower cord lesion. Inter-peak somatosensory evoked potentials latency was normal in all cases, suggesting that ascending axonal potentials in the dorsal column fibres may be synchronized. Segmental potentials of the lumbosacral response, originating from the post-synaptic activity of dorsal horn interneurons, are selectively affected in this syndrome resulting from the rostrocaudal displacement of the spinal cord due to tethering. Our findings in the clinical field are consistent with previous experimental evidence indicating a different sensitivity of the gray vs. white matter to progressive stretching.Resume: Potentiels evoques somesthesiques spinaux chez les patients atteints du syndrome Awfilum terminate. Nous avons etudie les changements electrophysiologiques presents chez six patients atteints du syndrome dufilitm terminate. Les malformations medullaires etaient detectees par resonance magnetique nucleaire. devaluation fonctionnelle de la moelle epiniere etait effectuee par l'analyse des potentiels evoques somesthesiques spinaux et corticaux (PES). L'electrospinogramme evoque etait enregistre au niveau des apophyses epineuses thoraciques et lombosacrees. Le potentiel lombosacre N22 etait selectivement atteint: il etait deplace en position rostrocaudale et son amplitude etait reduite et il etait absent chez les patients qui avaient des signes neurologiques indiquant une lesion segmentaire basse de la moelle epiniere. La latence interpics des PES etait normale chez tous les cas suggerant que les potentiels axonaux ascendants des fibres du faisceau posterieur sont synchronises. Les potentiels segmentates de la reponse lombosacr£e originant de I'activite post-synaptique des neurones intercalaires de la come posterieure de la moelle sont atteints selectivement dans ce syndrome du au deplaceinent rostrocaudal de la moelle 6piniere par fixation caudale. Nos observations cliniques sont en accord avec les donnees experimentales indiquant une sensibilite differente de la substance grise et de la substance blanche a retirement progressif.

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Tethering of the conus medullaris within the sacrum.

Cited by 37 publications

References 34 publications

Spinal Dysraphism in the Cervical and Dorsal Regions in Childhood

Spinal Dysraphism in the Cervical and Dorsal Regions in Childhood

Tethered Cord Syndrome Accompanied by Unilateral Muscle Atrophy in the Calf Muscle.

Spinal Somatosensory Evoked Potentials in Patients with Tethered Cord Syndrome

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