Tethered spinal cord syndrome is a neurological disorder caused by tissue attachments that limit the movement of the spinal cord within the spinal column. Attachments may occur congenitally at the base of the spinal cord (medullary cone) or they may develop near the site of an injury to the spinal cord. These attachments cause an abnormal stretching of the spinal cord. The course of the disorder is progressive.
We present two patients that were diagnosed at age of three months and three years, respectively. Final diagnosis was made by magnetic resonance imaging, and both patients were referred to University Clinic of Neurosurgery for further treatment.
Our aim is to illustrate the advantages of the early diagnostics of this progressive condition, to present diagnostic methods that are age-dependent and to illustrate the early clinical indicators for its existence.
1. Yamada S, Zinke DE, Sanders D. Pathophysiology of ‘tethered cord syndrome’. J Neurosurg 1981; 54: 494-503.
2. Duz B, Gocmen S, Secer HI, et al. Tethered cordsyndrome in adulthood. J Spinal Cord Med 2008; 31: 272-278.
3. 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 2008; 31: 371-384.
4. Greene C. Tethered Cord Syndrome. WIM 1995; 162(3): 258-259.
5. French BN. The embryology of spinal dysraphism. ClinNeurosurg 1983; 30: 295-340.
6. Iskandar BJ, Oakes WJ. Occult spinal dysraphism, in Albright AL, Pollack IF, Adelson FD (eds). Principles and Practices of Pediatric Neurosurgery. Stuttgart: Thieme 1999; 321-351.
7. Warder DE. Tethered cord syndrome and occult spinal dysraphism. Neurosurg Focus 2001; 10(1): E1.
8. Tubbs RS, Oakes WJ. Can the conus medullaris in normal position be tethered? Neurol Res 2004; 26: 727-731.
9. Warder DE, Oakes WJ. Tethered cord syndrome and the conus in a normal position. Neurosurgery 1993; 33: 374-378.
10. Warder DE, Oakes WJ. Tethered cord syndrome: the lowlying and the normally positioned conus. Neurosurgery 1994; 34: 597-600.
11. Yamada S, Knerium DS, Mandybur GM, et al. Pathophysiology of tethered cord syndrome and other complex factors. NeurolRes 2004; 26: 722-726.
12. Bui CJ, Tubbs RS, Oakes WJ. Tethered cord syndrome in children: a review. Neurosurg Focus 2007; 23(2): E2.
13. Oakes WJ. The borderlands of the primary tethered cord syndrome. ClinNeurosurg 1996; 43: 188-202.
14. Powell KR, Cherry JD, Hougen TJ, et al. A prospective search for congenital dermal abnormalities of the cranio-spinal axis. J Pediatr 1975; 87: 744-750.
15. Walton M, Bass J, Soucy P. Tethered cord with anorectal malformation, sacral anomalies and presacral masses: an under-recognized association. Eur J PediatrSurg 1995; 5: 59-62.
16. Kirks DR, Merten DF, Filston HC, et al. The Currarino triad: complex of anorectal malformation, sacral bony abnormality, and presacral mass. PediatrRadiol 1984; 14: 220-225.
17. Johnson DL, Levy LM. Predicting outcome in the tethered cord syndrome: a study of cord motion. PediatrNeurosurg 1995; 22: 115-119.
18. McCullough DC, Levy LM, DiChiro G, et al. Toward the prediction of neurological injury from tethered cord: investigation of cord motion with magnetic resonance. Pediatr Neurosurg 1990-1991; 16: 3-7.
19. Palmer LS, Richards I, Kaplan WE. Subclinical changes in bladder function in children presenting with nonurological symptoms of tethered cord syndrome. J Urol 1998; 159: 231-234.
20. Bui CJ, Tubbs RS, Oakes WJ. Tethered cord syndrome in children: a review. Neurosurg Focus 2007; 23(2): E2.
21. Chestnut R, James HE, Jones KL. The Vater association and spinal dysraphia. PediatrNeurosurg 1992; 18: 144-148.
22. Davidoff AM, Thompson CV, Grimm J, et al. Occult spinal dysraphism in patients with anal agenesis. J Pediatric Surg 1991; 26: 1001-1005.
23. Kirks DR, Merten DF, Filston HC, et al. The Currarino triad: complex of anorectal malformation, sacral bony abnomality, and presacral mass. PediatrRadiol 1984; 14: 220-225.
24. Walton M, Bass J, Soucy P. Tethered cord with anorectal malformation, sacral anomalies and presacral masses: an under-recognizedassociation. Eur J PediatrSurg 1995; 5: 59-62.
25. Sysoev KV, Tadevosyan AR, Nazinkina YV, et al. Surgical treatment outcomes in children with tethered spinal cord syndrome. A prognosis on the basis of spinal 3T MRI tractography. ZhVoprNeirokhirIm N NBurdenko 2016; 80(3): 66-73.
26. Ben-Siera L, Ponger P, Miller E, et al. Low-risk lumbar skin stigmata in infants: the role of ultrasound screening. J Pediatr 2009; 155: 864-869.
27. Boop FA, Russell A, Chadduck WM. Diagnosis and management of the tethered cord syndrome. J Ark Med Soc 1992; 89: 328-331.
28. Quencer RM, Montalvo BM, Naidich TP, et al. Intraoperative sonography in spinal dysraphism and syringohydromyelia. Am J Roentgenol 1987; 148: 1005-1013.