Reversal of longstanding neurological deficits after a late release of tethered spinal cord.
The importance of early surgery for tethered cord syndrome in the pediatric population is well established. Optimal treatment and prognosis of tethered cord in adults, on the other hand, is less clear. Some advocate a conservative approach in asymptomatic patients, while others recommend early detethering in all patients. For symptomatic patients, however, there is a consensus in favor of early surgery to prevent progression of neurological deficit. Many studies have reported cessation of neurological decline or reversal of recently acquired neurological deficits in patients with adult tethered cord syndrome. There are limited data in the literature about late surgery for the treatment of tethered spinal cords when the neurological deficits are longstanding. We report on a 37-year-old woman who demonstrated dramatic neurological improvement after surgical release of a tethered spinal cord more than 20 years after the onset of progressive neurological deficits.
Gupta
Gaurav
G
Department of Neurological Surgery, UMDNJ-New Jersey Medical School, Newark, New Jersey 07103, USA.
Heary
Robert F
RF
Michaels
Jennifer
J
D000328:Adult; D002607:Charcot-Marie-Tooth Disease / Q000175:diagnosis / Q000601:surgery; D018450:Disease Progression; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009422:Nervous System Diseases / Q000175:diagnosis / Q000503:physiopathology*; D009436:Neural Tube Defects / Q000503:physiopathology / Q000601:surgery*; D010808:Physical Examination / Q000379:methods; D011183:Postoperative Complications / Q000175:diagnosis; D011379:Prognosis; D012189:Retrospective Studies; D013116:Spinal Cord / Q000503:physiopathology / Q000601:surgery; D016896:Treatment Outcome