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Type I split cord malformation and tethered cord syndrome in an adult patient: A case report and literature review

BACKGROUND: In a split cord malformation (SCM), the spinal cord is divided longitudinally into two distinct hemicords that later rejoin. This can result in a tethered cord syndrome (TCS). Rarely, TCS secondary to SCM presents in adulthood. Here, we present an adult female with Type I SCM resulting i...

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Autores principales: D’Agostino, Erin N., Calnan, Daniel R., Makler, Vyacheslav I., Khan, Imad, Kanter, John H., Bauer, David F.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6744800/
https://www.ncbi.nlm.nih.gov/pubmed/31528428
http://dx.doi.org/10.25259/SNI-66-2019
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author D’Agostino, Erin N.
Calnan, Daniel R.
Makler, Vyacheslav I.
Khan, Imad
Kanter, John H.
Bauer, David F.
author_facet D’Agostino, Erin N.
Calnan, Daniel R.
Makler, Vyacheslav I.
Khan, Imad
Kanter, John H.
Bauer, David F.
author_sort D’Agostino, Erin N.
collection PubMed
description BACKGROUND: In a split cord malformation (SCM), the spinal cord is divided longitudinally into two distinct hemicords that later rejoin. This can result in a tethered cord syndrome (TCS). Rarely, TCS secondary to SCM presents in adulthood. Here, we present an adult female with Type I SCM resulting in TCS and a review of literature. CASE DESCRIPTION: A 57-year-old female with a history of spina bifida occulta presented with a 2-year history of worsening back and left leg pain, difficulty with ambulation, and intermittent urinary incontinence; she had not responded to conservative therapy. Magnetic resonance imaging (MRI) revealed a tethered cord secondary to lumbar type I SCM. The patient underwent an L1–S1 laminectomy for resection of the bony septum with cord detethering. At 2-month follow-up, the patient had improvement in her motor symptoms and less pain. In literature, 25 cases of adult-onset surgically managed SCM with TCS were identified (between 1936 and 2018). Patients averaged 37 years of age at the time of diagnosis, and 56% were female. CONCLUSION: TCS can present secondary to SCM in adulthood and is characterized predominantly by back and leg pain.
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spelling pubmed-67448002019-09-16 Type I split cord malformation and tethered cord syndrome in an adult patient: A case report and literature review D’Agostino, Erin N. Calnan, Daniel R. Makler, Vyacheslav I. Khan, Imad Kanter, John H. Bauer, David F. Surg Neurol Int Case Report BACKGROUND: In a split cord malformation (SCM), the spinal cord is divided longitudinally into two distinct hemicords that later rejoin. This can result in a tethered cord syndrome (TCS). Rarely, TCS secondary to SCM presents in adulthood. Here, we present an adult female with Type I SCM resulting in TCS and a review of literature. CASE DESCRIPTION: A 57-year-old female with a history of spina bifida occulta presented with a 2-year history of worsening back and left leg pain, difficulty with ambulation, and intermittent urinary incontinence; she had not responded to conservative therapy. Magnetic resonance imaging (MRI) revealed a tethered cord secondary to lumbar type I SCM. The patient underwent an L1–S1 laminectomy for resection of the bony septum with cord detethering. At 2-month follow-up, the patient had improvement in her motor symptoms and less pain. In literature, 25 cases of adult-onset surgically managed SCM with TCS were identified (between 1936 and 2018). Patients averaged 37 years of age at the time of diagnosis, and 56% were female. CONCLUSION: TCS can present secondary to SCM in adulthood and is characterized predominantly by back and leg pain. Scientific Scholar 2019-06-07 /pmc/articles/PMC6744800/ /pubmed/31528428 http://dx.doi.org/10.25259/SNI-66-2019 Text en Copyright: © 2019 Surgical Neurology International http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-Share Alike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.
spellingShingle Case Report
D’Agostino, Erin N.
Calnan, Daniel R.
Makler, Vyacheslav I.
Khan, Imad
Kanter, John H.
Bauer, David F.
Type I split cord malformation and tethered cord syndrome in an adult patient: A case report and literature review
title Type I split cord malformation and tethered cord syndrome in an adult patient: A case report and literature review
title_full Type I split cord malformation and tethered cord syndrome in an adult patient: A case report and literature review
title_fullStr Type I split cord malformation and tethered cord syndrome in an adult patient: A case report and literature review
title_full_unstemmed Type I split cord malformation and tethered cord syndrome in an adult patient: A case report and literature review
title_short Type I split cord malformation and tethered cord syndrome in an adult patient: A case report and literature review
title_sort type i split cord malformation and tethered cord syndrome in an adult patient: a case report and literature review
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6744800/
https://www.ncbi.nlm.nih.gov/pubmed/31528428
http://dx.doi.org/10.25259/SNI-66-2019
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