Pure tethered cervical cord and review of literature

Abstract

Tethering of the spinal cord in the lumbosacral region with myelomeningocele is a well-known phenomenon. Only sporadic cases of tethering along the rest of the neuraxis, including the hindbrain, cervical, and thoracic spinal cord have been documented, always along with some associated congenital malformations (hydrocephalus, Chiari malformation, myelomeningocele, meningocele, hamartomatous stalk, spina bifida occulta, intramedullary lipoma, intradural fibrous adhesions, the fusion of the sixth and seventh cervical vertebrae, split cord malformation, or low-lying cord). In this report, 14-year-old male developed symptoms related to tethering of the cervical spinal cord, but without any associated congenital malformations, that is the pure tethered cervical cord. This causes his moribund status and makes the manuscript unique and contributes to the hitherto literature. The authors discuss the diagnosis, treatment, and postoperative course of this entity. The uniqueness in treatment is that we have operated the case without the help of intraoperative somatosensory evoked potentials and motor evoked potential from posterolateral approach under local anesthesia.

A Novel Untethering and Duraplasty Technique for Postsurgical Tethered Spinal Cord

“…PPPM has been well-described in the setting of intramedullary spinal cord tumor resection and secondarily occurs when the dorsal pial surface of the surgically exposed spinal cord adheres to the dorsal dura [2][3][4][5][6]. Surgical correction of PPPM usually involves intradural exploration and lysis of adhesions that carries the risk of injuring the spinal cord.…”