Tethered cord
| Classification according to ICD-10 | |
|---|---|
| Q06.8 | Other specified congenital malformations of the spinal cord |
| ICD-10 online (WHO version 2019) | |
Tethered cord (German "tied cord") describes a pathological attachment of the caudal (lower) parts of the spinal cord with increased tension on the nerve fibers and corresponding disorders.
causes
It is based on either congenital malformations of the spinal cord such as meningomyelocele , lipomeningomyelocele or hidden (occult) disorders such as a spinal lipoma . For example, fat infiltration ( lipomatosis ) of the filum terminale can impede the ascent of the cone during growth.
Less often, as a result of scarring after an operation in the area of the lumbar spine, spinal cord extensions such as the filum terminale can grow together with the spinal cord sheath through a fibrous cord.
pathology
As a result of this attachment, the lower section of the spinal cord, the conus medullaris, is unusually deep (so-called cone depression ). The associated pull on the spinal cord can cause neurological disorders.
clinic
Outwardly recognizable signs of the disease are often atypical hairiness and the appearance of nevi in the area of the lesion. Pay attention to a difference in size of the feet.
Meningomyelocele is also observed in 20% of cases .
Diagnosis
In newborns and infants , the diagnosis can already be made by means of sonography and later in detail by means of magnetic resonance imaging .
treatment
Therapy is the surgical relief of the spinal cord by removing the adhesions.
Individual evidence
- ↑ DA Hertzler, JJ DePowell, CB Stevenson, FT Mangano: Tethered cord syndrome: a review of the literature from embryology to adult presentation. In: Neurosurgical Focus , Volume 29, No. 1, July 2010, p. E1, doi: 10.3171 / 2010.3.FOCUS1079 , PMID 20593997 (Review).
- ↑ W. Schuster, D. Färber (Ed.): Children's radiology. Imaging diagnostics. Springer, 1996, ISBN 3-540-60224-0 .
