Medical Student The Ohio State University College of Medicine Columbus, Ohio, United States
Introduction: Tethered cord syndrome (TCS) results from pathological stretching of the spinal cord and results in a range of motor and sensory deficits. The current gold standard for the management of TCS is a detethering procedure aimed at releasing the tension in the cord. An emerging alternative intervention is spinal cord shortening (SCS). In this study, the authors describe their experience treating a case of TCS via SCS.
Methods: A retrospective chart review was conducted at a tertiary medical center in which patient characteristics, outcomes, imaging, and operative notes were collected. Additionally, prior reports describing the surgical management of TCS were reviewed.
Results: The authors report a case of a 66-year-old male with a history of spina bifida and likely myelomeningocele that was repaired in infancy with a resultant tethered cord. He had previously undergone L4-L5 decompression and posterior pedicle screw fusion as well as spinal cord detethering 4 years prior and presented to our clinic with worsening lower extremity pain and weakness as well as bladder dysfunction. SCS at T12 was recommended. Following SCS, the patient reported resolution of his preoperative neurogenic neuropathic pain. He also reported significant improvement in the function and strength of his legs as well as bladder sensation.
Conclusion : SCS provides patients an alternative treatment avenue that can provide comparable levels of clinical improvement while bypassing some of the complications associated with detethering.
