scholarly journals Spinal cord stimulation for recurrent tethered cord syndrome in a pediatric patient: case report

2016 ◽  
Vol 18 (1) ◽  
pp. 105-110 ◽  
Author(s):  
Rachana Tyagi ◽  
Carolyn Kloepping ◽  
Shruti Shah
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Treatment Options ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Dorsal Spinal Cord ◽  
Increased Risk ◽  
Permanent Implant ◽  
Dorsal Spinal ◽  
Initial Results

The authors present a patient with a lipomyelomeningocele and worsening back pain due to recurrent tethered cord syndrome. Because of the increased risk and unlikely improvement in symptoms with repeated surgical untethering, she was offered an alternative treatment with a trial of dorsal spinal cord stimulation. She had an excellent response to the percutaneous trial, and a permanent implant was placed, with good initial results. The authors review her case as well as the treatment options, indications, and outcomes for recurrent tethered cord syndrome.

Spinal integration of antidromic mediated cutaneous vasodilation during dorsal spinal cord stimulation in the rat

1999 ◽  
Vol 260 (3) ◽  
pp. 173-176 ◽  
Author(s):  
Kirk W. Barron ◽  
John E. Croom ◽  
Crystal A. Ray ◽  
Margaret J. Chandler ◽  
Robert D. Foreman
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Dorsal Spinal Cord ◽  
Cutaneous Vasodilation ◽  
Dorsal Spinal

Dorsal Spinal Cord Stimulation in the Treatment of Multiple Sclerosis

Neurosurgery ◽  
1979 ◽  
Vol 5 (2) ◽  
pp. 225-230 ◽  
Author(s):  
Ronald F. Young ◽  
Stanley J. Stanley
Keyword(s):  
Multiple Sclerosis ◽  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Symptomatic Treatment ◽  
Symptomatic Improvement ◽  
Sensory Function ◽  
Dorsal Spinal Cord ◽  
Sphincter Function ◽  
Walking Velocity ◽  
Dorsal Spinal

Abstract Previously published work indicated significant improvement in the symptoms of multiple sclerosis with dorsal spinal cord stimulation. In this study 23 patients with multiple sclerosis documented by history, examination, laboratory studies, and clinical course were treated with dorsal spinal cord stimulation and followed for 19 to 45 months (mean, 32 months). Preand postoperative clinical assessment was carried out using the Kurtzke Scale. Walking velocity, upper limb coordination, sphincter function, and sensory function were also evaluated quantitatively. No statistically significant objective improvement in any of these measures was demonstrated. Fifty per cent of the patients initially reported subjective symptomatic improvement, but this declined to 30% at last follow-up. Fifteen of 23 patients experienced complications related mainly to the hardware used and required a total of 21 subsequent operative procedures for correction of these complications. These results do not support the continued clinical use of dorsal spinal cord stimulation in the symptomatic treatment of multiple sclerosis.

Vertebral column subtraction osteotomy for recurrent tethered cord syndrome in adults: a cadaveric study

2006 ◽  
Vol 4 (6) ◽  
pp. 478-484 ◽  
Author(s):  
Andrew W. Grande ◽  
P. Colby Maher ◽  
Chad J. Morgan ◽  
Ondrej Choutka ◽  
Benjamin C. Ling ◽  
...  
Keyword(s):  
Spinal Cord ◽  
Vertebral Column ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Thoracolumbar Junction ◽  
Neural Element ◽  
Nerve Roots ◽  
Tension Reduction ◽  
Increased Risk ◽  
Fresh Frozen

Object The standard treatment for lumbosacral tethered cord syndrome (TCS) in adults is surgical detethering. In patients with recurrent TCS, additional detethering operations are associated with increased risk of complications and subsequent scar formation. The authors studied the effect of undertaking a vertebral column subtraction osteotomy (VCSO) at the thoracolumbar junction to shorten the vertebral column and reduce neural element tension. Methods A model of TCS, developed in fresh-frozen human cadavers, was evaluated in three experiments. In Experiment 1, VCSO of 20 to 25 mm was performed at the T11–12 level. The vertebral column was sequentially shortened and the reduction in tension was measured separately in the terminal filum and the L-1 to S-3 or S-4 nerve roots. In Experiments 2 and 3 the reduction in tension was measured in the spinal cord after a VCSO and after simulating a traditional detethering operation. Vertebral column shortening produced tension reduction in all experiments. Tension decreased to less than 0.6 g in the terminal filum, L1–S3/4 nerve roots, and spinal cord after closure of a 20- to 25-mm VCSO. The mean ± standard deviation of the Δtension/Δdistance was −0.242 ± 0.019 g/mm for the terminal filum, −0.246 ± 0.019 g/mm for the lumbar nerve roots, and −0.216 ± 0.040 g/mm for the sacral nerve roots. A simulated traditional detethering operation required significant neural element release (detethering) to achieve spinal cord tension reduction equivalent to VCSO. Conclusions A VCSO significantly reduced neural tension at the thoracolumbar junction. This novel procedure may provide an alternative to traditional surgical detethering when scarring is excessive and the risk of complications and retethering are high.

scholarly journals Spinal Cord Stimulation inpatient with Tethered Cord syndrome: A Case Report

2020 ◽  
Vol 5 (8) ◽  
Keyword(s):  
Spinal Cord ◽  
Spinal Cord Stimulation ◽  
Pain Treatment ◽  
Case Reports ◽  
Tethered Cord ◽  
Similar Efficacy ◽  
Tethered Cord Syndrome ◽  
Intractable Pain ◽  
History Of ◽  
Myelomeningocele Repair

Background: Neuromodulation techniques are an important part of the chronic refractory neuropathic pain treatment. Their effectiveness is insufficiently documented in patients with tethered cord syndrome. Case Description: We present the case of a 32-year-old woman with a history of myelomeningocele repair, followed by a detethering surgery complicated with cerebral fluid leakage. Her intractable pain in her left leg and low back was successfully treated with spinal cord stimulation. Pain intensity decreased from 8/10 to 1-2/10 on her visual analogue scale without regular analgesic intake and her quality of life improved significantly. Conclusions: A review of the literature documents only three case reports of similar efficacy of spinal cord stimulation in the treatment of pain in adult patients with tethered cord syndrome.

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