Tethered Spinal Cord
- Most
present in the 1st and 2nd decades with a female
predominance
- Etiology:
- Congenital
– Lipomyelomeningocele, thickened filum terminale, diastematomyelia,
neurenteric cyst, dermoid
- Acquired
– Arachnoiditis, trauma, s/p repair of myelomeningocele
- Subtle:
- Subtle
atrophy, pain (especially in legs with exercise), progressive orthopedic
foot deformities, scoliosis, ascending motor loss, bowel/bladder
incontinence
- Frequently
seen as delayed complication after repair of myelomeningocele or excision
lipoma
- Diagnosis:
- 50% have
cutaneous sign (dimple, skin tag, hemangiomatous nevi, hairy patch)
- MRI of
spine reveals low lying conus (below L2-3 interspace and dorsally
displaced)
- Treatment:
Surgical detethering