Pathophysiology of tethered cord syndrome and similar complex disorders.
Tethered cord syndrome (TCS) is a stretch-induced functional disorder of the spinal cord due to the fact that its caudal portion is anchored by an inelastic structure. The functional lesion of TCS is generally situated in the lumbosacral cord, and many authors have shown that the syndrome is reversible via surgery to untether the cord. To clarify the expressions relevant to TCS, such as "cord tethering" and "tethered cord," the authors have formulated three categories. These categories include cases that show the anatomical appearance of spinal cord stretching. Among them, Category 1 is isolated to represent the "true TCS." The authors focus their discussion of the pathophysiology of TCS on Category 1 to explain the impaired oxidative metabolism and electrophysiological derangements within the tethered spinal cord, which is the primary intrinsic cause of the dysfunction. Furthermore, they extend the discussion to the extrinsic (outside the spinal cord) factors and other complex conditions that mimic TCS.
Yamada
Shokei
S
Department of Neurosurgery, Loma Linda University School of Medicine, Loma Linda, California 92354, USA. yamada1000.gmail.com
Won
Daniel J
DJ
Pezeshkpour
Gholam
G
Yamada
Brian S
BS
Yamada
Shoko M
SM
Siddiqi
Javed
J
Zouros
Alexander
A
Colohan
Austin R T
AR
D000818:Animals; D002420:Cauda Equina / Q000473:pathology; D004195:Disease Models, Animal; D044882:Glucose Metabolism Disorders / Q000209:etiology; D006801:Humans; D009436:Neural Tube Defects / Q000175:diagnosis* / Q000378:metabolism / Q000503:physiopathology*; D010084:Oxidation-Reduction; D013116:Spinal Cord / Q000378:metabolism / Q000503:physiopathology / Q000601:surgery