Thoracolumbar surgery for degenerative spine diseases complicated with tethered cord syndrome:A case report  

作　　者：Yue-Tian Wang Guan-Zhang Mu Hao-Lin Sun 

机构地区：[1]Department of Orthopedics,Peking University First Hospital,Beijing 100034,China

出　　处：《World Journal of Clinical Cases》2022年第28期10375-10383,共9页世界临床病例杂志

摘　　要：BACKGROUND Tethered cord syndrome(TCS) secondary to split cord malformation(SCM) is rare in adulthood.There is as yet no consensus about the optimal treatment method for adult patients with SCMs and degenerative spine diseases such as lumbar stenosis,spondylolisthesis and ossification of the ligamentum flavum(OLF).The tethered cord poses a great challenge to the decompression and fusion procedures for the intraoperative stretching of the spinal cord,which might lead to deteriorated neural deficits.Here,we report on a case to add our treatment experience to the medical literature.CASE SUMMARY We treated a 67-year-old female patient with type II SCM suffering from lumbar disc herniation,degenerative lumbar spondylolisthesis and thoracic OLF.The patient underwent thoracolumbar spinal fusion and decompression surgery for severe lower back pain,extensive left lower limb muscle weakness and intermittent claudication.After the thoracolumbar surgery,without stretching the tethered cord,the patient achieved complete relief of pain and lower extremity weakness at final follow-up.CONCLUSION For adult patients with underlying TCS secondary to SCM coupled with thoracic OLF and lumbar spondylolisthesis,a thoracolumbar fusion surgery could be safe and effective with the tethered cord untreated.It is critical to design individualized surgical protocols to reduce the stretch of the low-lying spinal cord.

关 键 词：Tethered cord syndrome Split cord malformations Ossification of ligamentum flavum SPONDYLOLISTHESIS Thoracolumbar surgery Case report 

分 类 号：R687.3[医药卫生—骨科学]