Abstract
Study design:
Single case report.
Objectives:
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.
Conclusion:
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.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Lapsiwala SB, Iskandar BJ . The tethered cord syndrome in adults with spina bifida occulta. Neurol Res 2004; 26: 735–740.
Yamada S, Lonser RR . Adult tethered cord syndrome. J Spinal Disord 2000; 13: 319–323.
Pang D, Wilberger JE Jr . Tethered cord syndrome in adults. J Neurosurg 1982; 57: 32–47.
Kramer JL, Dvorak M, Curt A . Thoracic disc herniation in a patient with tethered cord and lumbar syringomyelia and diastematomyelia: magnetic resonance imaging and neurophysiological findings. Spine 2009; 34: E484–E487.
Srinivas S, Shetty R, Collins I . Symptomatic lumbar disc protrusion causing progressive myelopathy in a low-lying cord. Global Spine J 2012; 2: 115–118.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Competing interests
The authors declare no conflict of interest.
Rights and permissions
About this article
Cite this article
Endo, F., Iizuka, H., Iizuka, Y. et al. Myelopathy due to lumbar disc herniation in the presence of a tethered cord. Spinal Cord 52 (Suppl 1), S11–S13 (2014). https://doi.org/10.1038/sc.2014.67
Received:
Revised:
Accepted:
Published:
Issue date:
DOI: https://doi.org/10.1038/sc.2014.67
