Reversal of longstanding neurological deficits after a late release of tethered spinal cord

Abstract

<jats:p>The importance of early surgery for tethered cord syndrome in the pediatric population is well established. Optimal treatment and prognosis of tethered cord in adults, on the other hand, is less clear. Some advocate a conservative approach in asymptomatic patients, while others recommend early detethering in all patients. For symptomatic patients, however, there is a consensus in favor of early surgery to prevent progression of neurological deficit. Many studies have reported cessation of neurological decline or reversal of recently acquired neurological deficits in patients with adult tethered cord syndrome. There are limited data in the literature about late surgery for the treatment of tethered spinal cords when the neurological deficits are longstanding. We report on a 37-year-old woman who demonstrated dramatic neurological improvement after surgical release of a tethered spinal cord more than 20 years after the onset of progressive neurological deficits.</jats:p>

Evaluation and management of tethered cord syndrome in occult spinal dysraphism: Recommendations from the international children's continence society

“…Since the advent of MRI, a low‐lying spinal cord is readily diagnosed in asymptomatic patients or those with fixed deficits. A U.S. inpatient hospital database review highlighted a steady rise in operations performed for “TCS.” While recommending surgery is tempting in asymptomatic children with an abnormal MRI or any deficit or deformity, improvement in long‐standing, fixed deficits is uncommon after SCU . Surgery is only advocated if observation risks outweigh intervention …”

“…54 While recommending surgery is tempting in asymptomatic children with an abnormal MRI or any deficit or deformity, improvement in long-standing, fixed deficits is uncommon after SCU. 55 Surgery is only advocated if observation risks outweigh intervention. 11 Despite these risks, our understanding of the natural history of most OSDs is incomplete.…”

Advantages Roles of Epiduroscopic Techniques in Diagnostic plus management of Lumbar Canal Stenosis

“…All forms involve the pulling of the spinal cord at the base of the spinal canal. Which were excluded from the patients selected for this study, the inclusion was only for primary anomalies of tethered cord syndrome 24 .…”

Metabolomics of neurological disorders in India

“…Tethered cord syndrome is a neurological disorder that arises from spinal cord fixation due to limited spinal cord movement 57 . Continuous stretching and enhanced spinal cord tension in a child potentially lead to several neurological disorders and other symptoms.…”

“…During embryonic evolution, the defective termination in the neural tube results in the inflexible structures in children, which leads to spina bifida. Tethered cord syndrome can be treated through early age surgery 57,58 …”