Of the 2515 patients, 85 adults with a tethered cord syndrome formed the basis of this study. Google Scholar 14. Increasingly, adults in their middle years with spina bifida tell us that they are experiencing symptoms of tethered cord. Tethered cord syndrome (TCS) refers to a group of neurological disorders that relate to malformations of the spinal cord. Tethered cord syndrome (TCS) usually presents at birth or during childhood with symptoms including back pain radiating to both buttocks and legs, sensory deficit of the lower extremities, and loss of bladder/bowel control [1â3]. Of the 2515 patients, 85 adults with a tethered cord syndrome formed the basis of this study. Its symptomatic onset in adulthood is uncommon, though the underlying pathology resembles that of TCS in childhood. 2001;10(1):e71â5. Adults rarely present with tethered cord syndrome, and this review examines whether it is justifiable to perform surgical intervention in this group. Tethered spinal cord syndrome (TCS) is a condition of overstretching or compression of the caudal part of the spinal cord caused by various spinal lesions, such as a tight filum terminale or an intraspinal lipoma. Tethered Cord in Adults The legs may feel numb or weak, and may lose muscle. Further, adults can present after a precipitating event (ie, disc herniation), suggesting that the adult tethered cord may be under just enough tension as to not cause symptoms, and any increased stretch or tension that reduces blood flow could lead to hypoxia and tethered cord syndrome (22). 1-9 Though it is a well-recognized cause of neurological deterioration in childhood, its symptomatic onset in adulthood is uncommon. Symptoms related to a congenital tethered cord occur most commonly in childhood, so it was initially regarded as a pediatric problem; but in many patients, the diagnosis is not established until symptoms manifest in adulthood. The age range varied from 22 to 65 years. The most common surgery for tethered cord involves cutting the anchoring tissue on the bottom called the filum terminale. Tethered cord syndrome in adults. This is called âdetetheringâ. Adult tethered cord syndrome (ATCS) is a rare entity, and the diagnosis is still challenging [3, 4]. Neurosurg Focus. BACKGROUND: The tethered cord syndrome (TCS) consists of an abnormally low conus medullaris tethered by a thickened filum terminale or various forms of spinal dysraphism. Surgery for Tethered Cord. Complications include infection, bleeding, and damage to the spinal cord, which may result in paralysis or loss of bowel or bladder function. Spine. Tethered cord syndrome is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal column. Tethered cord syndrome (TCS) is a condition that can be present in EDS, where the spinal cord is attached to surrounding tissue in a way that creates elongation and tension of the nervous tissue, leading to low back pain, loss of bladder ⦠Volume 52, Issue 4, October 1999, Pages 362-370. UROLOGY/GI: Neurogenic bladder*, Frequent Urinary tract infection (> 3 per year), Incontinence, ... characterized by clinical findings consistent with a tethered cord syndrome, but with the conus ending in a normal position and Filum > 2mm but no fatty infiltration. Various forms include tight filum terminale, lipomeningomyelocele, split cord malformations (diastematomyelia), dermal sinus tracts, and dermoids.All forms involve the pulling of the spinal cord at the base of the spinal canal, literally a tethered cord. Thankfully, tethered cord syndrome is now considered a clinical entity of importance. To aid with this, a definition for true tethered cord syndrome now exists. There are only two large series of adult TCS in the English literature 15, 20. The symptoms listed below are some of the ways in which tethered spinal cord syndrome may be exhibited in children: Lesion on the lower back Fatty tumor or deep dimple on the lower back Skin discoloration on the lower back Hairy patch on the lower back Back pain, worsened by ⦠Background: Tethered cord syndrome (TCS) is a complex clinicopathologic entity, mostly described in children with limited number of studies describing in adults. This unique and rare subgroup of patients presents with characteristic features of TCS, but unlike children, pain is a predominant clinical symptom. Background: Dysraphic lesions in adults, presenting clinically as tethered cord syndrome (TCS), are relatively rare, and their optimal management remains controversial.Patients and Methods: We performed a retrospective analysis of our pediatric database over a period of last 7 years to focus on the adult TCS. Symptoms of tethered cord become more pronounced during periods of rapid growth due to increased stretching of the spinal cord. The number of adults in whom congenital TCS is diagnosed continues to grow as a result of better imaging and recognition of this syndrome. The tethering effect was caused either by a split cord malformation, a thick filum terminale, a conus medullaris lipoma with extradural extension, or various combinations of these mechanisms. Method. For instance, primary tethered cord syndrome may refer to all congenital causes in general, closed spinal dysraphisms as a group, or tight filum terminale in particular 3,8,9,15,17. For Educational Use Only - Fair Use - Neurological spine surgeon Dr. Robert Bray and OBGYN Dr. Lisa Masterson explained tethered cord syndrome.rn It is considered progressive. Diagnosis of congenital or acquired tethered cord is relatively rare in adults. Solmaz I, Izci Y, Albayrak B, Cetinalp E, Kural C, Sengul G, Gocmez C, Pausal S, Tuzun Y. Tethered cord syndrome in childhood: special emphasis on the surgical technique, and review of the literature with our experience. Symptoms of tethered cord are age-specific. The tethered cord syndrome (TCS) is a disease of childhood. Its clinical spectrum comprises low back pain, neurological deficits such as distal motor weakness and trophic and sensory disturbances in the legs, urological symptoms and such musculoskeletal signs as scoliosis or foot deformities. Congenital tethered spinal cord syndrome in adults. Tethered Cord Syndrome. Young adults_Pain, Spasticity and Hyperreflexia 2. Adults experience different symptoms of tethered cord syndrome as the condition tends to have gradual changes that are time based. The neurological surgeon makes an incision in the lower back to expose the site where the spinal cord is pinned, then frees it by releasing the stuck portion of the cord. Older children and adults may experience back pain, leg pain, weakness in the lower extremities and/or fatigue with walking. ¶ Background. Classifications of etiologies as "primary" or "secondary" tethered cord syndrome are heterogeneous and conflicting in the literature. This study includes 11 patients with a TCS. Tethered cord syndrome (TCS) is rare, but no one knows exactly how prevalent it is because it commonly goes undiagnosed. Author information: (1)Department of Neurosurgery, Military Hospital, Izmir, Turkey. Neurophysiological monitoring for safe surgical tethered cord syndrome release in adults. Tethered cord syndrome in adults Symptoms of Tethered Cord . Tethered cord Syndrome The abnormal stretching puts tension on the spinal cord and nerves, this causes problems with the messages, getting to and from the legs, feet, toes, bladder, bowel and can cause some problems with sexual function. It can affect children and adults, but the causes of TCS differ. In adults, symptoms of tethered cord often develop slowly, but they can become quite severe. Written by renowned specialists, the second edition of Tethered Cord Syndrome in Children and Adults is a comprehensive text on the essentials of clinical management for this complex disorder. 10-23 Eleven cases of TCS are presented here. Tethered cord syndrome is a rare neurological condition. The adult variant of the syndrome seems not to be as rare as once thought. Lee, G Y Paradiso, G Tator, C H Gentili, F Massicotte, E M Fehlings, M G Surgical management of tethered cord syndrome in adults: indications, techniques, and long-term outcomes in 60 patients J Neurosurg Spine 2006 4 2 123 131 These symptoms include: Back pains â since tethered cord syndrome is a spinal cord anomaly, the person in question experiences constant back pains. In babies and children, TCS is nearly always congenital, meaning the child was born with his or her spinal cord attached to the spinal column or to the skin. The definition limits the disorder to patients who exhibit neurological signs and symptoms due to inelastic structures that anchor the caudal end of the spinal cord. Symptoms may include back pain that radiates to the legs, hips, and the genital or rectal areas. The most common treatment for tethered spinal cord is a lumbar laminectomy to release the tethered cord. The tethered spinal cord syndrome is more often encountered in children, but does also occur in adults. For this procedure, the patient is placed under general anesthesia. Tethered cord syndrome tends to be a progressive disorder, and can remain undiagnosed until adulthood. Symptoms. Akay KM(1), ErÅahin Y, Cakir Y. The tethered cord syndrome (TCS) consists of an abnormally low conus medullaris tethered by a thickened filum terminale or various forms of spinal dysraphism. Between 2003 and 2017, we performed surgical intervention in 32 adults with tethered cord syndrome. The severity of the condition and the associated signs and symptoms vary from person to person. Clinical, radiological findings and outcome were reviewed in these adult patients with TCS. Although the cord has been tethered since growth ended in their late teens, the symptoms begin after many years owing to âwear and tearâ on the cord ⦠Quiñones-Hinojosa A(1), Gadkary CA, Gulati M, von Koch CS, Lyon R, Weinstein PR, Yingling CD. It can be congenital or acquired and appear in childhood or adulthood.
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