Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10375
Peer-review started: July 5, 2022
First decision: July 14, 2022
Revised: July 21, 2022
Accepted: August 24, 2022
Article in press: August 24, 2022
Published online: October 6, 2022
Processing time: 84 Days and 1.6 Hours
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.
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 inter
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.
Core Tip: Tethered cord syndrome (TCS) secondary to split cord malformation (SCM) is rare in adulthood. We present a patient who underwent thoracolumbar surgery for thoracic ossification of the ligamentum flavum and lumbar spondylolisthesis complicated with TCS. 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. A literature review of SCM in adults was also performed.