title: Myelopathy due to lumbar disc herniation in the presence of a tethered cord.
abstract: METHODS
  Single case report.
  
  
  OBJECTIVE
  To present a case of lumbar disc herniation causing compression of a tethered cord that was successfully treated with lumbar decompression and fusion.
  
  
  BACKGROUND
  A tethered cord is a rare pathology associated with a congenital spinal malformation, spinal dysraphism. Furthermore, myelopathy due to lumbar disc herniation in the presence of a tethered cord is extremely rare.
  
  
  METHODS
  Single case report.
  
  
  RESULTS
  A 43-year-old male with a history of spina bifida presented to our clinic for an evaluation of a progressive spastic gait disturbance and numbness in the lower limbs. A neurological examination revealed muscle weakness and pyramidal tract signs in the lower limbs. Magnetic resonance imaging of the lumbar spine showed disc herniation at L2-3 causing compression of a low-lying cord. Surgical intervention, including herniotomy via a posterolateral approach and instrumented posterolateral fusion, was performed, and a good outcome was achieved 1 year after the surgery.
  
  
  CONCLUSIONS
  The potential for lumbar disc herniation in the presence of a tethered cord should be taken into account in the differential diagnosis of spinal pathologies causing spastic gait disturbances. Furthermore, posterior decompression and fusion is a useful treatment option in such cases.
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: F
authors.initials: F
authors.lastname: Endo
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Iizuka
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: Y
authors.initials: Y
authors.lastname: Iizuka
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Kobayashi
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: T
authors.initials: T
authors.lastname: Mieda
authors.affiliation: Department of Orthopaedic Surgery, Gunma University Graduate School of Medicine, Maebashi, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Takagishi
mesh_terms: D000328:Adult; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D009436:Neural Tube Defects / Q000150:complications*; D013116:Spinal Cord / Q000473:pathology*; D013118:Spinal Cord Diseases / Q000209:etiology*; D014965:X-Rays