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©The Author(s) 2022.
World J Clin Cases. Oct 6, 2022; 10(28): 10375-10383
Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10375
Published online Oct 6, 2022. doi: 10.12998/wjcc.v10.i28.10375
Table 1 The intraoperative somatosensory evoked potentials and motor evoked potentials
SEP (left) | SEP (right) | MEP (left) | MEP (right) | |||||||||
P40 in ms | N50 in ms | Amplitude in μV | P40 in ms | N50 in ms | Amplitude in μV | P40 in ms | N50 in ms | Amplitude in μV | P40 in ms | N50 in ms | Amplitude in μV | |
Baseline | 41.0 | 50.3 | 1.3 | 40.0 | 46.5 | 1.0 | 50.2 | 47.7 | 85.8 | 45.0 | 52.2 | 61.3 |
After lamina exposure | 41.5 | 49.8 | 1.3 | 39.5 | 47.7 | 1.0 | 51.5 | 49.0 | 83.7 | 44.0 | 47.0 | 41.9 |
After thoracic decompression | 42.5 | 51.2 | 0.7 | 40.5 | 46.5 | 0.8 | 48.3 | 46.0 | 186.6 | 52.5 | 50.5 | 284.2 |
After lumbar decompression | 38.8 | 49.5 | 0.6 | 38.5 | 46.5 | 0.7 | 48.0 | 44.0 | 149.4 | 50.0 | 46.0 | 336.1 |
Table 2 Literature review of split spinal malformation/tethered cord syndrome in spinal surgery
Ref. | Country | Study type | Number of patients | Gender/age in yr | SCM type | Symptoms | Main diagnosis | Operation | Principles | Problems |
Oh et al[13], 2021 | United States | Case report | 1 | Female/50 | Type II | Back and radiating leg pain; leg numbness; bowel/bladder incontinence | Spondylolisthesis | L5/S1 ALIF with posterior fixation | First to perform untethering procedure before spinal fusion surgery | High-volume drain output; pseudomeningocele; surgical exploration with wound debridement and repair |
Kobets et al[5], 2021 | United States | Case Series | 6 | 4 Females/35-62 | Type II | Radiating leg pain; lower extremity paresthesia; bladder and bowel dysfunction | / | / | Filamentectomy | Symptom recurrence |
Chang et al[24], 2020 | United States | Case report | 1 | Male/40 | NM | leg pain; sensory changes; hyperreflexia, and gait disturbance | Lumbar disc herniation | Full endoscopic lumbar diskectomy | Treating the responsible lesions in a minimally invasive method without spinal cord detethering surgery | NM |
Kaminker et al[9], 2000 | United Kingdom | Case report | 1 | Male/38 | Type I | Bilateral leg pain and neurogenic claudication | Lumbar spinal stenosis | Posterior decompression | Decompression with subtotal resection of the bony bar | Cerebrospinal fluid leak |
Breton et al[15], 2020 | United States | Case report | 1 | Female/79 | NM | Leg pain; progressive gait deterioration and bilateral leg weakness | Lumbar spinal stenosis; spondylolisthesis | Sublaminoplasty for spinal cord decompression with onlay arthrodesis | Conduct a minimally invasive surgery with tethered cord untreated | NM |
Hui et al[26], 2014 | China | Case report | 1 | Male/23 | Type I | Unstable walking and progressed numbness in the lower limbs | Kyphoscoliosis | Posterior segmental pedicle screw instrumented fusion with vertebral column resection | Vertebral column resection above bony spur to shorten the spine and decrease the stretched power on the spinal cord. | No complications |
Endo et al[17], 2014 | Japan | Case report | 1 | Male/43 | NM | Progressive spastic gait disturbance; numbness; muscle weakness and pyramidal tract signs in the lower limbs | Lumbar disc herniation | Herniotomy via a posterolateral approach and instrumented posterolateral fusion | Decompression and posterolateral fusion without intervertebral fusion | No complications |
Srinivas et al[23], 2012 | United Kingdom | Case report | 1 | Female/77 | NM | Severe low back pain and progressive paraparesis | Lumbar disc herniation | Posterior decompression | Indirectly decompression by the falling back spinal cord | Deep wound infection |
König et al[25], 2012 | United Kingdom | Case report | 1 | Female/26 | Type II | Severe low back pain, and bilateral L5/S1 sciatica | Spondylolisthesis | Anterior in situ fusion coupled with pedicle screw fixation | Anterior fusion to minimize manipulation of neural structures | No complications |
Kawamura et al[27], 2010 | Japan | Case report | 2 | Male/69; Male/36 | NM | 1 Legs and low back pain with intermittent claudication; 2 Numbness and severe muscle weakness in the lower limbs | Lumbar spinal stenosis | Pedicle subtraction osteotomy and yellow ligament resection | Pedicle subtraction osteotomy to shorten the spine | NM |
Kramer[28], 2009 | Canada | Case report | 1 | Female/54 | NM | Progressive pain and sensorimotor symptoms in the lower back and limbs | Thoracic disc herniation | Posterolateral partial vertebral body resection and decompression | Osteotomy to shorten the spine | NM |
- Citation: Wang YT, Mu GZ, Sun HL. Thoracolumbar surgery for degenerative spine diseases complicated with tethered cord syndrome: A case report. World J Clin Cases 2022; 10(28): 10375-10383
- URL: https://www.wjgnet.com/2307-8960/full/v10/i28/10375.htm
- DOI: https://dx.doi.org/10.12998/wjcc.v10.i28.10375