Tethered cord syndrome in adults: Clinical article

Journal of Neurosurgery: Spine

Volumn 15, Issue 3, 2011, Pages 258-270

  Klekamp, Jörg ^a  

^a Christliches Krankenhaus GmbH   (Germany)

Author keywords

Dermoid cyst; Neurenteric cyst; Spinal lipoma; Split cord malformation; Syringomyelia; Tethered cord

Indexed keywords

ADULT; AGED; ARTICLE; ATAXIA; CLINICAL EFFECTIVENESS; CONSERVATIVE TREATMENT; CONUS MEDULLARIS; DETERIORATION; DYSESTHESIA; EPIDERMOID CYST; FEMALE; FILUM TERMINALE; FOLLOW UP; HAMARTOMA; HEMATOMA; HUMAN; HYPESTHESIA; IMPETIGO; LIQUORRHEA; MAJOR CLINICAL STUDY; MALE; MOTOR DYSFUNCTION; OUTPATIENT; PAIN; PROGNOSIS; QUESTIONNAIRE; RECURRENCE RISK; SPINAL CORD MALFORMATION; SPINAL CORD SURGERY; SPINAL LIPOMA; SYRINGOMYELIA; TERATOMA; TETHERED CORD SYNDROME; TREATMENT REFUSAL; URINARY TRACT INFECTION;

ADULT; AGED; CAUDA EQUINA; CERVICAL VERTEBRAE; DERMOID CYST; FEMALE; FOLLOW-UP STUDIES; HUMANS; LIPOMA; MAGNETIC RESONANCE IMAGING; MALE; MIDDLE AGED; NERVOUS SYSTEM DISEASES; NEURAL TUBE DEFECTS; NEUROSURGERY; PAIN; PROSPECTIVE STUDIES; RECURRENCE; SPINAL CORD; SPINAL CORD NEOPLASMS; SPINAL DISEASES; SYRINGOMYELIA; TREATMENT OUTCOME;

EID: 80052568920     PISSN: 15475654     EISSN: 15475646     Source Type: Journal    
DOI: 10.3171/2011.4.SPINE10504     Document Type: Article

References (76)

1. Agnoli A.L., Laun A., Schönmayr R.: Enterogenous intraspinal cysts. J Neurosurg 61:834-840, 1984 (Pubitemid 15203733)
2. Aoyama T., Ohtaki M., Koyanagi I., Kawamura M., Chiba M.: Syringo-subarachnoidal shunting to correct unilateral leg deformity in a child with terminal syringomyelia: Case report. Childs Nerv Syst 24:869-873, 2008
3. Arai H., Sato K., Okuda O., Miyajima M., Hishii M., Nakanishi H., et al: Surgical experience of 120 patients with lumbosacral lipomas. Acta Neurochir (Wien) 143:857-864, 2001 (Pubitemid 32930162)
4. Arai Y., Yamauchi Y., Tsuji T., Fukasaku S., Yokota R., Kudo T: Spinal neurenteric cyst. Report of two cases and review of forty-one cases reported in Japan. Spine (Phila Pa 1976) 17: 1421-1424, 1992
5. Aufschnaiter K., Fellner F., Wurm G.: Surgery in adult onset tethered cord syndrome (ATCS): Review of literature on occasion of an exceptional case. Neurosurg Rev 31:371-384, 2008
6. Bassiouni H., Hunold A., Asgari S., Hübschen U., König H.J., Stolke D.: Spinal intradural juxtamedullary cysts in the adult: Surgical management and outcome. Neurosurgery 55:1352-1360, 2004
7. Bauer D.F., Shoja M.M., Loukas M., Oakes W.J., Tubbs R.S.: Study of the effects of flexion on the position of the conus medullaris. Childs Nerv Syst 24:1043-1045, 2008
8. Beaumont A., Muszynski C.A., Kaufman B.A.: Clinical significance of terminal syringomyelia in association with pediatric tethered cord syndrome. Pediatr Neurosurg 43:216-221, 2007 (Pubitemid 46558917)
9. Brickner W.M.: Spina bifida occulta. Am J Med Sci 155:473-502, 1918
10. Bristow R.G., Laperriere N.J., Tator C., Milosevic M., Wong C.S.: Post-operative radiotherapy for recurrent dermoid cysts of the spine: A report of 3 cases. J Neurooncol 33:251-256, 1997 (Pubitemid 27241313)
11. Caird J., Flynn P., McConnell R.S.: Significant clinical and radiological resolution of a spinal cord syrinx following the release of a tethered cord in a patient with an anatomically normal conus medullaris. Case report. J Neurosurg Pediatr 1:396-398, 2008 (Pubitemid 351670709)
12. Chang I.C.: Surgical experience in symptomatic congenital intraspinal cysts. Pediatr Neurosurg 40:165-170, 2004
13. Chavda S.V., Davies A.M., Cassar-Pullicino V.N.: Enterogenous cysts of the central nervous system: A report of eight cases. Clin Radiol 36:245-251, 1985 (Pubitemid 15009337)
14. Choux M., Lena G., Genitori L., Foroutan M.: The surgery of occult spinal dysraphism. Adv Tech Stand Neurosurg 21:183-238, 1994
15. Chumas P.D.: The role of surgery in asymptomatic lumbosacral spinal lipomas. Br J Neurosurg 14:301-304, 2000
16. Colak A., Pollack I.F., Albright A.L.: Recurrent tethering: A common long-term problem after lipomyelomeningocele repair. Pediatr Neurosurg 29:184-190, 1998 (Pubitemid 29029797)
17. Düz B., Gocmen S., Secer H.I., Basal S., Gönül E.: Tethered cord syndrome in adulthood. J Spinal Cord Med 31:272-278, 2008
18. Ehni G., Love J.G.: Intraspinal lipomas: Report of cases, review of the literature, and clinical and pathologic study. Arch Neurol Psychiat 53:1-28, 1945
19. Endoh M., Iwasaki Y., Koyanagi I., Hida K., Abe H.: Spontaneous shrinkage of lumbosacral lipoma in conjunction with a general decrease in body fat: case report. Neurosurgery 43: 150-152, 1998 (Pubitemid 28287794)
20. Erkan K., Unal F., Kiris T., Karalar T.: Treatment of terminal syringomyelia in association with tethered cord syndrome: Clinical outcomes with and without syrinx drainage. Neurosurg Focus 8(3):e9, 2000
21. Finn M.A., Walker M.L.: Spinal lipomas: Clinical spectrum, embryology, and treatment. Neurosurg Focus 23(2):E10, 2007
22. Fujimura Y., Kimura F., Ishida S., Shinoda K., Ohsawa N.: [An adult case of tethered cord syndrome with lipoma and thoracolumbar syringomyelia presenting slow progressive muscular atrophy in the lower limbs.] Rinsho Shinkeigaku 34: 918-921, 1994 (Jpn)
23. Garg A., Gupta V., Gaikwad S., Deol P., Mishra N.K., Suri A., et al: Isolated central canal rupture of spinal dermoid: report of two cases. Australas Radiol 47:194-197, 2003 (Pubitemid 36783120)
24. Gower D.J., Del Curling O., Kelly D.L. Jr, Alexander E. Jr: Diastematomyelia - A 40- Year experience. Pediatr Neurosci 14: 90-96, 1988
25. Goyal A., Singh D., Singh A.K., Gupta V., Sinha S.: Spontaneous rupture of spinal dermoid cyst with disseminated lipid droplets in central canal and ventricles. J Neurosurg Sci 48: 63-65, 2004 (Pubitemid 39486989)
26. Guthkelch A.N., Hoffmann G.T.: Tethered spinal cord in association with diastematomyelia. Surg Neurol 15:352-354, 1981 (Pubitemid 11099384)
27. Hajnovic L., Trnka J.: Tethered spinal cord syndrome - The importance of time for outcomes. Eur J Pediatr Surg 17:190-193, 2007 (Pubitemid 47262555)
28. Herman J.M., McLone D.G., Storrs B.B., Dauser R.C.: Analysis of 153 patients with myelomeningocele or spinal lipoma reoperated upon for a tethered cord. Presentation, management and outcome. Pediatr Neurosurg 19:243-249, 1993 (Pubitemid 23282255)
29. Hsu A.R., Hou L.C., Veeravagu A., Barnes P.D., Huhn S.L.: Resolution of syringomyelia after release of tethered cord. Surg Neurol 72:657-661, 2009
30. Hüttmann S., Krauss J., Collmann H., Sörensen N., Roosen K.: Surgical management of tethered spinal cord in adults: Report of 54 cases. J Neurosurg 95 (2 Suppl):173-178, 2001 (Pubitemid 33730834)
31. Iskandar B.J., Fulmer B.B., Hadley M.N., Oakes W.J.: Congenital tethered spinal cord syndrome in adults. Neurosurg Focus 10(1):e7, 2001
32. Iskandar B.J., Oakes W.J., McLaughlin C., Osumi A.K., Tien R.D.: Terminal syringohydromyelia and occult spinal dysraphism. J Neurosurg 81:513-519, 1994 (Pubitemid 24303275)
33. Kang J.K., Lee K.S., Jeun S.S., Lee I.W., Kim M.C.: Role of surgery for maintaining urological function and prevention of retethering in the treatment of lipomeningomyelocele: Experience recorded in 75 lipomeningomyelocele patients. Childs Nerv Syst 19:23-29, 2003
34. Kaplan E.L., Meier P.: Nonparametric estimation from incomplete observations. J Am Stat Assoc 53:457-481, 1958
35. Karadag D., Karagülle A.T., Erden A., Erden I.: MR imaging of a ruptured intraspinal dermoid tumour with fat droplets in the central spinal canal. Australas Radiol 46:444-446, 2002 (Pubitemid 35463808)
36. Karnofsky D.A., Burchenal J.H.: The clinical evaluation of chemotherapeutic agents in cancer, in MacLeod CM (ed): Evaluation of Chemotherapeutic Agents. New York: Columbia University Press, 1949, pp 191-205
37. Kasliwal M.K., Sinha S., Sharma B.S., Garg A.: Symptomatic central canal rupture heralding the presence of an asymptomatic conus dermoid. J Neurooncol 84:39-40, 2007 (Pubitemid 47103441)
38. Kesler H., Dias M.S., Kalapos P.: Termination of the normal conus medullaris in children: A whole-spine magnetic resonance imaging study. Neurosurg Focus 23(2):E7, 2007
39. Klekamp J., Raimondi A.J., Samii M.: Occult dysraphism in adulthood: Clinical course and management. Childs Nerv Syst 10:312-320, 1994 (Pubitemid 24224910)
40. Klekamp J., Samii M.: Introduction of a score system for the clinical evaluation of patients with spinal processes. Acta Neurochir (Wien) 123:221-223, 1993 (Pubitemid 23271996)
41. Klekamp J., Samii M.: Surgery of Spinal Tumors. Heidelberg: Springer Verlag, 2007
42. Klekamp J., Samii M.: Syringomyelia - Diagnosis and Treatment. New York: Springer Verlag, 2001
43. Koyanagi I., Iwasaki Y., Hida K., Abe H., Isu T., Akino M.: Surgical treatment supposed natural history of the tethered cord with occult spinal dysraphism. Childs Nerv Syst 13:268-274, 1997 (Pubitemid 27293386)
44. Koyanagi I., Iwasaki Y., Hida K., Abe H., Isu T., Akino M., et al: Factors in neurological deterioration and role of surgical treatment in lumbosacral spinal lipoma. Childs Nerv Syst 16: 143-149, 2000 (Pubitemid 30202944)
45. Kulkarni A.V., Pierre-Kahn A., Zerah M.: Conservative management of asymptomatic spinal lipomas of the conus. Neurosurgery 54:868-875, 2004 (Pubitemid 38437281)
46. La Marca F., Grant J.A., Tomita T., McLone D.G.: Spinal lipomas in children: Outcome of 270 procedures. Pediatr Neurosurg 26:8-16, 1997 (Pubitemid 27444014)
47. Lad S.P., Patil C.G., Ho C., Edwards M.S., Boakye M.: Tethered cord syndrome: Nationwide inpatient complications and outcomes. Neurosurg Focus 23(2):E3, 2007
48. Lagae L., Verpoorten C., Casaer P., Vereecken R., Fabry G., Plets C.: Conservative versus neurosurgical treatment of tethered cord patients. Z Kinderchir 45 (Suppl 1):16-17, 1990
49. Lapsiwala S.B., Iskandar B.J.: The tethered cord syndrome in adults with spina bifida occulta. Neurol Res 26:735-740, 2004 (Pubitemid 39552718)
50. Lunardi P., Missori P., Gagliardi F.M., Fortuna A.: Long-term results of the surgical treatment of spinal dermoid and epidermoid tumors. Neurosurgery 25:860-864, 1989 (Pubitemid 20073376)
51. Maiuri F., Gangemi M., Cavallo L.M., De Divitiis E.: Dysembryogenetic spinal tumours in adults without dysraphism. Br J Neurosurg 17:234-238, 2003 (Pubitemid 37100484)
52. Mathew P., Todd N.V.: Intradural conus and cauda equina tumours: A retrospective review of presentation, diagnosis and early outcome. J Neurol Neurosurg Psychiatry 56:69-74, 1993 (Pubitemid 23062983)
53. Messori A., Polonara G., Serio A., Gambelli E., Salvolini U.: Expanding experience with spontaneous dermoid rupture in the MRI era: Diagnosis and follow-up. Eur J Radiol 43:19-27, 2002 (Pubitemid 34626992)
54. Muthukumar N: Congenital spinal lipomatous malformations: part I - Classification. Acta Neurochir (Wien) 151:179-188, 197, 2009
55. Muthukumar N.: Congenital spinal lipomatous malformations: part II - Clinical presentation, operative findings, and outcome. Acta Neurochir (Wien) 151:189-197, 2009
56. Ng W.H., Seow W.T.: Tethered cord syndrome preceding syrinx formation - Serial radiological documentation. Childs Nerv Syst 17:494-496, 2001 (Pubitemid 32684690)
57. Pang D.: Split cord malformation: Part II: Clinical syndrome. Neurosurgery 31:481-500, 1992
58. Pang D.: Ventral tethering in split cord malformation. Neurosurg Focus 10(1):e6, 2001
59. Pang D., Dias M.S., Ahab-Barmada M.: Split cord malformation: Part I: A unified theory of embryogenesis for double spinal cord malformations. Neurosurgery 31:451-480, 1992
60. Pang D., Zovickian J., Oviedo A.: Long- Term outcome of total and near- Total resection of spinal cord lipomas and radical reconstruction of the neural placode: part I- Surgical technique. Neurosurgery 65:511-529, 2009
61. Pang D., Zovickian J., Oviedo A.: Long-term outcome of total and near-total resection of spinal cord lipomas and radical reconstruction of the neural placode, part II: Outcome analysis and preoperative profiling. Neurosurgery 66:253-273, 2010
62. Peter J.C.: Occult dysraphism of the spine. A retrospective analysis of 88 operative cases, 1979-1989. S Afr Med J 81: 351-354, 1992
63. Pierre-Kahn A., Zerah M., Renier D., Cinalli G., Sainte-Rose C., Lellouch-Tubiana A., et al: Congenital lumbosacral lipomas. Childs Nerv Syst 13:298-335, 1997 (Pubitemid 27388185)
64. Radmanesh F., Nejat F., El Khashab M.: Dermal sinus tract of the spine. Childs Nerv Syst 26:349-357, 2010
65. Rajpal S., Tubbs R.S., George T., Oakes W.J., Fuchs H.E., Hadley M.N., et al: Tethered cord due to spina bifida occulta presenting in adulthood: A tricenter review of 61 patients. J Neurosurg Spine 6:210-215, 2007 (Pubitemid 47066072)
66. Rauzzino M.J., Tubbs R.S., Alexander E. III, Grabb P.A., Oakes W.J.: Spinal neurenteric cysts and their relation to more common aspects of occult spinal dysraphism. Neurosurg Focus 10(1):e2, 2001
67. Samuels R., McGirt M.J., Attenello F.J., Garcés Ambrossi G.L., Singh N., Solakoglu C., et al: Incidence of symptomatic retethering after surgical management of pediatric tethered cord syndrome with or without duraplasty. Childs Nerv Syst 25:1085-1089, 2009
68. Satar N., Bauer S.B., Shefner J., Kelly M.D., Darbey M.M.: The effects of delayed diagnosis and treatment in patients with an occult spinal dysraphism. J Urol 154:754-758, 1995
69. Sattar M.T., Bannister C.M., Turnbull I.W.: Occult spinal dysraphism - The common combination of lesions and the clinical manifestations in 50 patients. Eur J Pediatr Surg 6 (Suppl 1):10-14, 1996
70. Scatliff J.H., Kendall B.E., Kingsley D.P., Britton J., Grant D.N., Hayward R.D.: Closed spinal dysraphism: Analysis of clinical, radiological, and surgical findings in 104 consecutive patients. AJR Am J Roentgenol 152:1049-1057, 1989 (Pubitemid 19125138)
71. Schmidt D.M., Robinson B., Jones D.A.: The tethered spinal cord. Etiology and clinical manifestations. Orthop Rev 19: 870-876, 1990 (Pubitemid 20374773)
72. Van Calenbergh F., Vanvolsem S., Verpoorten C., Lagae L., Casaer P., Plets C.: Results after surgery for lumbosacral lipoma: The significance of early and late worsening. Childs Nerv Syst 15:439-443, 1999 (Pubitemid 29458254)
73. Xenos C., Sgouros S., Walsh R., Hockley A.: Spinal lipomas in children. Pediatr Neurosurg 32:295-307, 2000
74. Yamada S., Iacono R.P., Andrade T., Mandybur G., Yamada B.S.: Pathophysiology of tethered cord syndrome. Neurosurg Clin N Am 6:311-323, 1995
75. Yamada S., Won D.J., Pezeshkpour G., Yamada B.S., Yamada S.M., Siddiqi J., et al: Pathophysiology of tethered cord syndrome and similar complex disorders. Neurosurg Focus 23(2):E6, 2007
76. Zide B., Constantini S., Epstein F.J.: Prevention of recurrent tethered spinal cord. Pediatr Neurosurg 22:111-114, 1995