Cargando…

Pediatric pathology all grown up – An interesting case of adult tethered spinal cord

BACKGROUND: Cervical myelopathy in an adult is typically the result of degenerative disease or trauma. Dysraphism is rarely the cause. CASE DESCRIPTION: The authors report the case of a 35-year-old male drywall installer who presented with 2 years of progressive left upper extremity weakness, numbne...

Descripción completa

Detalles Bibliográficos
Autores principales: Laurent, Dimitri, Bardhi, Olgert, Gregory, Jason, Yachnis, Anthony, Governale, Lance S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Scientific Scholar 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7655999/
https://www.ncbi.nlm.nih.gov/pubmed/33194295
http://dx.doi.org/10.25259/SNI_641_2020
_version_ 1783608285918658560
author Laurent, Dimitri
Bardhi, Olgert
Gregory, Jason
Yachnis, Anthony
Governale, Lance S.
author_facet Laurent, Dimitri
Bardhi, Olgert
Gregory, Jason
Yachnis, Anthony
Governale, Lance S.
author_sort Laurent, Dimitri
collection PubMed
description BACKGROUND: Cervical myelopathy in an adult is typically the result of degenerative disease or trauma. Dysraphism is rarely the cause. CASE DESCRIPTION: The authors report the case of a 35-year-old male drywall installer who presented with 2 years of progressive left upper extremity weakness, numbness, and hand clumsiness. Only upon detailed questioning did he mention that he had neck surgery just after birth, but he did not know what was done. He then also reported that he routinely shaved a patch of lower back hair, but denied bowel, bladder, or lower extremity dysfunction. Magnetic resonance imaging of the cervical spine demonstrated T2 hyperintensity at C4-C5 with dorsal projection of the neural elements into the subcutaneous tissues concerning for a retethered cervical myelomeningocele. Lumbar imaging revealed a diastematomyelia at L4. He underwent surgical intervention for detethering and repaired of the cervical myelomeningocele. Four months postoperatively, he had almost complete resolution of symptoms, and imaging showed a satisfactory detethering. The diastematomyelia remained asymptomatic and is being observed. CONCLUSION: Tethered cervical cord is a rare cause for myelopathy in the adult patient. In the symptomatic patient, surgical repair with detethering is indicated to prevent disease progression and often results in clinical improvement.
format Online
Article
Text
id pubmed-7655999
institution National Center for Biotechnology Information
language English
publishDate 2020
publisher Scientific Scholar
record_format MEDLINE/PubMed
spelling pubmed-76559992020-11-13 Pediatric pathology all grown up – An interesting case of adult tethered spinal cord Laurent, Dimitri Bardhi, Olgert Gregory, Jason Yachnis, Anthony Governale, Lance S. Surg Neurol Int Case Report BACKGROUND: Cervical myelopathy in an adult is typically the result of degenerative disease or trauma. Dysraphism is rarely the cause. CASE DESCRIPTION: The authors report the case of a 35-year-old male drywall installer who presented with 2 years of progressive left upper extremity weakness, numbness, and hand clumsiness. Only upon detailed questioning did he mention that he had neck surgery just after birth, but he did not know what was done. He then also reported that he routinely shaved a patch of lower back hair, but denied bowel, bladder, or lower extremity dysfunction. Magnetic resonance imaging of the cervical spine demonstrated T2 hyperintensity at C4-C5 with dorsal projection of the neural elements into the subcutaneous tissues concerning for a retethered cervical myelomeningocele. Lumbar imaging revealed a diastematomyelia at L4. He underwent surgical intervention for detethering and repaired of the cervical myelomeningocele. Four months postoperatively, he had almost complete resolution of symptoms, and imaging showed a satisfactory detethering. The diastematomyelia remained asymptomatic and is being observed. CONCLUSION: Tethered cervical cord is a rare cause for myelopathy in the adult patient. In the symptomatic patient, surgical repair with detethering is indicated to prevent disease progression and often results in clinical improvement. Scientific Scholar 2020-10-29 /pmc/articles/PMC7655999/ /pubmed/33194295 http://dx.doi.org/10.25259/SNI_641_2020 Text en Copyright: © 2020 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
Laurent, Dimitri
Bardhi, Olgert
Gregory, Jason
Yachnis, Anthony
Governale, Lance S.
Pediatric pathology all grown up – An interesting case of adult tethered spinal cord
title Pediatric pathology all grown up – An interesting case of adult tethered spinal cord
title_full Pediatric pathology all grown up – An interesting case of adult tethered spinal cord
title_fullStr Pediatric pathology all grown up – An interesting case of adult tethered spinal cord
title_full_unstemmed Pediatric pathology all grown up – An interesting case of adult tethered spinal cord
title_short Pediatric pathology all grown up – An interesting case of adult tethered spinal cord
title_sort pediatric pathology all grown up – an interesting case of adult tethered spinal cord
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7655999/
https://www.ncbi.nlm.nih.gov/pubmed/33194295
http://dx.doi.org/10.25259/SNI_641_2020
work_keys_str_mv AT laurentdimitri pediatricpathologyallgrownupaninterestingcaseofadulttetheredspinalcord
AT bardhiolgert pediatricpathologyallgrownupaninterestingcaseofadulttetheredspinalcord
AT gregoryjason pediatricpathologyallgrownupaninterestingcaseofadulttetheredspinalcord
AT yachnisanthony pediatricpathologyallgrownupaninterestingcaseofadulttetheredspinalcord
AT governalelances pediatricpathologyallgrownupaninterestingcaseofadulttetheredspinalcord