[Progressive amyotrophy of a limb as the presenting symptom of anchored spinal cord syndrome with spinal lipoma].
OBJECTIVE
We present a case of progressive amyotrophy of a limb as the presenting symptom of the anchored spinal cord syndrome and review the principal clinical features of the syndrome, diagnostic tests which are useful in differentiating it from other conditions and its treatment.


METHODS
We describe a case of a young woman in whom the spinal cord was anchored by a spinal lipoma. At the onset of the disorder she complained of progressive muscular atrophy of the right leg and difficulty in dorsi-flexion of her right foot. Plain X-ray of the pelvis showed partial agenesis of the right lower hemisacrum and partial sacralization of L5. Lumbosacral CT and MR showed a lipoma to be present within the spinal canal and the thickened filum terminale anchored within the lipoma. During the next five months after diagnosis, the clinical picture worsened with paresia of flexo-extension of the right knee and of flexion of the right foot. Surgical treatment was therefore indicated.


CONCLUSIONS
The anchored spinal cord syndrome should be considered in the differential diagnosis of spinal cord disorders presenting in adults, when there are other malformations such as agenesis of the sacrum. Surgical treatment is always indicated when there is evidence of worsening clinical condition.
Masjuan Vallejo
J
J
Servicio de Neurología; Hospital Ramón y Cajal. Facultad de Medicina, Madrid, 28034, España. med022981@nacom.es
Herrero Valverde
A M
AM
Martínez San Millán
J
J
Heredero Sanz
J
J
Mera Campillo
J
J
D000293:Adolescent; D001284:Atrophy; D018450:Disease Progression; D005260:Female; D006801:Humans; D007866:Leg; D008067:Lipoma / Q000150:complications* / Q000175:diagnosis; D008159:Lumbar Vertebrae; D018482:Muscle, Skeletal / Q000473:pathology*; D012447:Sacrum; D013120:Spinal Cord Neoplasms / Q000150:complications* / Q000175:diagnosis; D013577:Syndrome