scholarly journals Importance of Physical Examination and Imaging in the Detection of Tethered Cord Syndrome

2019 ◽  
Vol 6 ◽  
pp. 2333794X1985141
Author(s):  
Lisa B. E. Shields ◽  
Ian S. Mutchnick ◽  
Dennis S. Peppas ◽  
Eran Rosenberg
Keyword(s):  
Magnetic Resonance Imaging ◽  
Spinal Dysraphism ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Resonance Imaging ◽  
Occult Spinal Dysraphism ◽  
Cutaneous Manifestations ◽  
Physical Examinations ◽  
Spinal Ultrasound ◽  
Prompt Diagnosis

Tethered cord syndrome (TCS) is a type of occult spinal dysraphism that may lead to permanent neurologic and orthopedic deficits. Infants with TCS may have lumbosacral cutaneous malformations (LsCMs). We studied 67 infants referred to a single pediatric urology practice for a urological concern unrelated to occult spinal dysraphism with no prior diagnosis of LsCM between March 1, 2015 and September 30, 2018. Each infant underwent a spinal ultrasound. If an abnormality was detected, they were referred to a pediatric neurosurgeon. The most common cutaneous manifestations were duplicated or bifurcated (46%) gluteal folds and gluteal asymmetry (16%). Fourteen (21%) of the 67 patients had an abnormal spinal ultrasound; 5 of the 14 infants underwent a lumbar magnetic resonance imaging. One infant had urodynamics studies and a tethered cord release. Pediatricians should be familiar with TCS and perform lumbar physical examinations for LsCMs suggestive of TCS to ensure prompt diagnosis and management and avoid potentially devastating complications.

scholarly journals Risk of occult spinal dysraphism based on lumbosacral cutaneous manifestations

2021 ◽  
Vol 9 ◽  
pp. 205031212110371
Author(s):  
Lisa BE Shields ◽  
Ian S Mutchnick ◽  
Michael W Daniels ◽  
Dennis S Peppas ◽  
Eran Rosenberg
Keyword(s):  
Spinal Dysraphism ◽  
Tethered Cord ◽  
Pediatric Urology ◽  
Tethered Cord Syndrome ◽  
Cutaneous Manifestation ◽  
Lumbar Region ◽  
Occult Spinal Dysraphism ◽  
Cutaneous Manifestations ◽  
Spinal Ultrasound ◽  
Neonates And Infants

Objectives: Occult spinal dysraphism is a congenital failure of fusion of the posterior vertebral arches with intact skin overlying the defect. Lumbosacral cutaneous manifestations are associated with a variable risk of occult spinal dysraphism. Tethered cord syndrome is a type of occult spinal dysraphism that puts abnormal traction on the spinal cord. This study analyzed neonates and infants who were referred to our pediatric urology practice and had evidence of lumbosacral cutaneous manifestation on physical examination. Methods: We reviewed the presence of lumbosacral cutaneous manifestations in neonates and infants evaluated in our pediatric urology clinic at our Institution over a 6-year period (1 March, 2015–28 February, 2021) with no prior diagnosis of lumbosacral cutaneous manifestation. All patients underwent a spinal ultrasound. Results: The most common lumbosacral cutaneous manifestations were bifurcated/duplicated gluteal folds (33%), gluteal asymmetry (19%), and sacral dimples (14%). A total of 34 (24%) patients had an abnormal spinal ultrasound; 15 (44%) of these infants underwent a lumbar magnetic resonance imaging. A coccygeal pit was statistically marginally higher in abnormal versus normal spinal ultrasound (p = 0.07). Patients with only one lumbosacral cutaneous manifestation (N = 121) were significantly more likely to have a normal spinal ultrasound compared to those with two or more lumbosacral cutaneous manifestation (N = 17) (79% vs 53%, p = 0.03). Conclusion: Due to the varying risk of certain lumbosacral cutaneous manifestations with occult spinal dysraphism, all patients with a lumbosacral cutaneous manifestation should undergo spinal ultrasound. This study also highlights the importance of urodynamic studies when there are abnormal cutaneous findings. Routine physical examinations of the lumbar region for cutaneous manifestations of occult spinal dysraphism are vital to ensure prompt management of tethered cord syndrome and avoid potentially devastating consequences.

Tethered cord syndrome in occult spinal dysraphism: Timing and outcome of surgical release

Neurology ◽  
1998 ◽  
Vol 50 (6) ◽  
pp. 1761-1765 ◽  
Author(s):  
L. Cornette ◽  
C. Verpoorten ◽  
L. Lagae ◽  
F. Van Calenbergh ◽  
C. Plets ◽  
...  
Keyword(s):  
Spinal Dysraphism ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Occult Spinal Dysraphism ◽  
Surgical Release

Tethered Cord Syndrome in Occult Spinal Dysraphism. Timing and Outcome of Surgical Release

1999 ◽  
pp. 1405-1406
Author(s):  
L. Cornette ◽  
C. Verpoorten ◽  
L. Lagae ◽  
F. Van Calenbergh ◽  
C. Plets ◽  
...  
Keyword(s):  
Spinal Dysraphism ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Occult Spinal Dysraphism ◽  
Surgical Release

Prevalence of Primary Tethered Cord Syndrome Associated with Occult Spinal Dysraphism in Primary School Children in Turkey

2005 ◽  
Vol 42 (1) ◽  
pp. 4-13 ◽  
Author(s):  
Gulsah Bademci ◽  
Meral Saygun ◽  
Funda Batay ◽  
Aytul Cakmak ◽  
Halil Basar ◽  
...  
Keyword(s):  
Primary School ◽  
School Children ◽  
Spinal Dysraphism ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Primary School Children ◽  
Occult Spinal Dysraphism

Magnetic resonance imaging in occult spinal dysraphism

1986 ◽  
Vol 16 (5) ◽  
pp. 412-416 ◽  
Author(s):  
R. A. C. Roos ◽  
G. J. Vielvoye ◽  
J. H. C. Voormolen ◽  
A. C. B. Peters
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Spinal Dysraphism ◽  
Resonance Imaging ◽  
Occult Spinal Dysraphism

Tethered cord syndrome in children: a review

2007 ◽  
Vol 23 (2) ◽  
pp. 1-9 ◽  
Author(s):  
Cuong J. Bui ◽  
R. Shane Tubbs ◽  
W. Jerry Oakes
Keyword(s):  
Spinal Cord ◽  
Surgical Treatment ◽  
Spinal Dysraphism ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Tethered Spinal Cord ◽  
Occult Spinal Dysraphism ◽  
Problematic Issue ◽  
A Minor ◽  
Minor Procedure

✓The treatment of a patient with symptoms of a tethered spinal cord and in whom a fatty infiltrated terminal filum is found is controversial. The authors review their experience and the literature regarding this aspect of occult spinal dysraphism. From experience, transection of a fatty terminal filum in patients with symptoms related to excessive caudal cord tension is a minor procedure that generally yields good results. The most problematic issue in the literature is what patients and symptoms are best suited to surgical treatment.

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