title: Complications after spinal anesthesia in adult tethered cord syndrome.
abstract: Since little has been reported about complications of spinal anesthesia in adult tethered cord syndrome (TCS), we sought to delineate the characteristics of the condition.A total of 4 cases of adult TCS after spinal anesthesia were reviewed. The medical charts of the patients were obtained. Anesthesia, which was combined spinal and epidural anesthesia or spinal anesthesia was performed, and follow-up were carried out in all patients.The most common neurological symptom of adult TCS before surgery was occasional severe pain in back, perineal region, or legs. Frequent micturition, diminished knee and ankle reflexes, and difficulty in bending were exhibited in partial patients. Paraesthesia of perineal region or/and lower extremities existed 2 to 3 days after spinal anesthesia in all the cases. Weakness of lower extremities existed in 1 case. Lumbar magnetic resonance imaging showed the low location of conus medullaris. At follow-up, 3 cases recovered completely within 3 weeks, and 1 case underwent permanent disability.These cases suggest anesthesiologists and surgeons alert to the association of adult TCS and spinal anesthesia. Spinal anesthesia should be prohibited in patients with adult TCS to prevent neurological damages.
authors.affiliation: Department of Neurology, The Second Affiliated Hospital, College of Medicine Department of Anesthesia, The First Affiliated Hospital, College of Medicine Department of Orthopedics, The Second Affiliated Hospital, College of Medicine, Xi'an Jiaotong University, Xi'an, China.
authors.forename: Jing-Jie
authors.initials: JJ
authors.lastname: Liu
authors.forename: Zheng
authors.initials: Z
authors.lastname: Guan
authors.forename: Zhen
authors.initials: Z
authors.lastname: Gao
authors.forename: Li
authors.initials: L
authors.lastname: Xiang
authors.forename: Feng
authors.initials: F
authors.lastname: Zhao
authors.forename: Sheng-Li
authors.initials: SL
authors.lastname: Huang
mesh_terms: D000328:Adult; D000775:Anesthesia, Spinal / Q000009:adverse effects*; D000075202:Contraindications; D006801:Humans; D009436:Neural Tube Defects / Q000150:complications* / Q000175:diagnosis; D009460:Neurologic Examination / Q000187:drug effects; D012189:Retrospective Studies