[The clinical problem of the tethered cord syndrome--a report of 3 personal cases].
Tethered cord syndrome is defined as a low state of the conus medullaris below the lumbar vertebra 2 after the neonatal period. Possible causes are: short thickened filum terminale, fibrotic ligaments, intradural lipomas. The clinical course is characterised by motoric and sensory deficits, disturbances of balance, neurogenic bladder disturbances, foot deformities and backache. A 3-year-old boy after operation of a lipomyelomeningocele at 2 months showed a one-sided leg shortening and a progressive neurogenic bladder and intestinal disturbance. The cause was a low state of the conus with a shortened filum terminale and a remainder of a lipoma. A 7-year-old boy after operation of a thoraco-lumbar meningomyelocele developed a progressive asymmetric paraspastic state with contractures. The neuro-radiological diagnosis of an intradural dermoid was verified on operation. A 10-year-old boy after operation of a covered lumbosacral meningocele showed a progressive backache which was connected with flexion. We found a low state of the conus through adhesions caused by scars which could be removed operatively. A collaborative treatment by the paediatric surgeon and the neuro-paediatrician of patients with dysraphic disturbances can prevent the severe consequences of the tethered cord problems with the co-operation and early intervention of the neuropaediatric surgeon.
Weissert
M
M
Ostschweizerisches Kinderspital, St. Gallen.
Gysler
R
R
Sörensen
N
N
D002420:Cauda Equina / Q000002:abnormalities*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008067:Lipoma / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery; D008297:Male; D008591:Meningomyelocele / Q000175:diagnosis / Q000601:surgery*; D011183:Postoperative Complications / Q000175:diagnosis; D013125:Spinal Neoplasms / Q000151:congenital* / Q000175:diagnosis / Q000601:surgery
Zur klinischen Problematik des Tethered-Cord-Syndroms--Bericht über drei eigene Beobachtungen.