Adult tethered cord syndrome mimicking lumbar disc disease
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Date
2008
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Abstract
Object: This paper reports four tethered cord cases who initially applied with lumbar disk disease symptoms. Materials and methods: All of them were investigated by magnetic resonance imaging (MRI) and somatosensory evoked potential (SSPE). In two patients, MRI revealed thick and fatty filum terminale, while in remaining two, the filum terminale appeared as normal in thickness. SSEP revealed pathological conduction values in all, and it was the main indicator for surgical sectioning in patients especially with normal MRI investigations. All patients had benefit from the surgical sectioning of the fila terminalia with either thick and fatty or normal appearance. Conclusion: A particular patient with lumbar disc disease symptoms having normal MRI should also be investigated for tight filum terminale. If there is no pathological appearance in MRI investigation (both in regard to disc herniation and thick and fatty filum terminale), SSEP investigation should be done to check whether a conduction block or delay is present, indicating cord tethering. © Springer-Verlag 2007.
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Adult , Cauda Equina , Evoked Potentials, Somatosensory , Follow-Up Studies , Humans , Intervertebral Disk , Lumbosacral Region , Magnetic Resonance Imaging , Middle Aged , Neural Tube Defects , adult , article , case report , differential diagnosis , drug treatment failure , evoked somatosensory response , filum terminale , follow up , histopathology , human , human tissue , lumbar disk hernia , nerve block , nuclear magnetic resonance imaging , postoperative period , priority journal , radicular pain , spinal cord surgery , tethered cord syndrome , treatment indication , urodynamics