title: Fecal incontinence as a predominant symptom in a case of multiply recurrent tethered cord: diagnosis and operative strategies.
abstract: Recurrent manifestations of tethered spinal cord after an initial operative intervention for a simple fatty filum terminale is fairly uncommon. The authors present the case of an unusual clinical course in which there were 3 distinct episodes of recurrence, each time presenting predominantly as fecal incontinence and resolving with operative intervention. Typical signs of tethering were absent on radiological evaluation, and operative intervention was based on clinical grounds. Intraoperatively, sacral nerve roots to the anal sphincter were found tethered to the filar stump with electrophysiological evidence of regained activity on disentanglement. To the best of the authors' knowledge, a similar clinical course or operative findings have not been reported.
authors.affiliation: Department of Neurological Surgery, NewYork-Presbyterian Hospital, Weill Cornell Medical College, New York, New York;|Neuroscience Institute, University EI Bosque, Bogota, Colombia; and.
authors.forename: Jose
authors.initials: J
authors.lastname: Behaine
authors.affiliation: Department of Neurological Surgery, NewYork-Presbyterian Hospital, Weill Cornell Medical College, New York, New York;|Department of Neurological Surgery, Ain Shams University, Cairo, Egypt.
authors.forename: Assem M
authors.initials: AM
authors.lastname: Abdel Latif
authors.affiliation: Department of Neurological Surgery, NewYork-Presbyterian Hospital, Weill Cornell Medical College, New York, New York;
authors.forename: Jeffrey P
authors.initials: JP
authors.lastname: Greenfield
mesh_terms: D001003:Anal Canal / Q000473:pathology / Q000503:physiopathology; D002420:Cauda Equina / Q000473:pathology / Q000503:physiopathology / Q000601:surgery; D002675:Child, Preschool; D005242:Fecal Incontinence / Q000209:etiology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009436:Neural Tube Defects / Q000150:complications / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery*; D019635:Neurosurgical Procedures / Q000379:methods*; D012008:Recurrence; D016896:Treatment Outcome
keywords: TCS = tethered cord syndrome; congenital; fatty filum terminale; incontinence; recurrence; tethered cord