TETHERED CORD SYNDROME COMPLICATING SPINA BIFIDA OCCULTA

Case summary Two castrated male cats, aged 8 months old (case 1) and 10 months old (case 2), showed a history of progressive paraparesis, an over-reaching pelvic limb gait, urinary incontinence and a palpable dermoid fistula. In case 1, the fistula was connected to the dural sac on the conus medullaris, and the tethered spinal cord was retracted caudally. In case 2, the tubular structure was connected to the dural sac on the thoracic spinal cord, and the tethered spinal cord was retracted dorsally. Tethered cord syndrome secondary to spina bifida aperta was suspected in both cats. Excision of the fistula and release of the tethered spinal cord was performed. A histopathological examination confirmed the diagnosis of a meningomyelocele in case 1 and a meningocele in case 2. Paraparesis improved postoperatively in both cats. However, urinary incontinence in case 1 remained partially unresolved. Relevance and novel information This is the first report to describe the imaging characteristics, surgical treatments and outcomes of two different types of tethered cord syndrome with spina bifida aperta in cats. Tethered cord syndrome with spina bifida aperta needs to be included in the differential diagnosis of slowly progressive paraparesis in younger cats with or without vesicorectal failure and a palpable dermoid fistula.

Download Full-text

Tethered Cord Syndrome: Clinical Signs and Results of Operation in 42 Patients with Spina Bifida Aperta and Occulta

European Journal of Pediatric Surgery ◽

10.1055/s-2008-1043279 ◽

1989 ◽

Vol 44 (S 1) ◽

pp. 5-7

Author(s):

J. Begeer ◽

G.P Wiertsema ◽

S.M. Breukers ◽

J.J. Mooy ◽

C.A. ter Weeme

Keyword(s):

Spina Bifida ◽

Clinical Signs ◽

Tethered Cord ◽

Tethered Cord Syndrome ◽

Spina Bifida Aperta

Download Full-text

Congress of Neurological Surgeons Systematic Review and Evidence-Based Guideline on the Incidence of Tethered Cord Syndrome in Infants With Myelomeningocele With Prenatal Versus Postnatal Repair

Neurosurgery ◽

10.1093/neuros/nyz266 ◽

2019 ◽

Vol 85 (3) ◽

pp. E417-E419 ◽

Cited By ~ 1

Author(s):

Catherine A Mazzola ◽

Rachana Tyagi ◽

Nadege Assassi ◽

David F Bauer ◽

Alexandra D Beier ◽

...

Keyword(s):

Spina Bifida ◽

Full Text ◽

Task Force ◽

Relevant Literature ◽

Tethered Cord ◽

The United States ◽

Tethered Cord Syndrome ◽

Folic Acid Deficiency ◽

Increased Risk ◽

Postnatal Closure

Abstract BACKGROUND The incidence of spina bifida (SB) is higher in the developing world as compared to the United States because of folic acid deficiency during pregnancy. Advances in technology have made prenatal repair of myelomeningocele (MM) possible. OBJECTIVE The objective of this guideline was to determine if there is a difference in the rate of development of tethered cord syndrome (TCS) in infants who had prenatal closure compared to infants who had MM repair after birth. METHODS The Guidelines Task Force developed search terms and strategies to search PubMed and Embase for the relevant literature published between 1966 and September 2016. Strict inclusion/exclusion criteria were used. Full text articles were reviewed and, when appropriate, included as evidence. RESULTS A total of 261 abstracts were reviewed. Fifty-four full-text articles were selected for further analysis. Three studies met inclusion criteria. CONCLUSION There was Class II evidence from 1 study and Class III evidence from another 2 studies demonstrating that TCS develops in infants with prenatal MM closure at an equal or higher rate than with postnatal closure. There was an increased risk of development of inclusion cysts in infants who underwent in utero closure. Continued surveillance for TCS and/or the development of inclusion cysts in children with prenatal and postnatal closure of MM is indicated (Level II). Differences between prenatal and postnatal repair with respect to the development of TCS and/or inclusion cysts should be considered alongside other relevant maternal and fetal outcomes when deciding upon a preferred method for MM closure. The full guideline can be found at https://www.cns.org/guidelines/guidelines-spina-bifida-chapter-6.

Download Full-text