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CC BY 4.0 · Journal of Child Science 2022; 12(01): e92-e103
DOI: 10.1055/s-0042-1757142
Original Article

Clinical Significance of Terminal Syringomyelia and Accompanying Congenital Anomalies of Neurosurgical Interest in Adult and Pediatric Patients with Tethered Cord Syndrome

Usame Rakip    #
1   Department of Neurosurgery, Afyonkarahisar Health Sciences University, Faculty of Medicine, Afyonkarahisar, Turkey
,
İhsan Canbek    #
1   Department of Neurosurgery, Afyonkarahisar Health Sciences University, Faculty of Medicine, Afyonkarahisar, Turkey
,
Serhat Yıldızhan 
1   Department of Neurosurgery, Afyonkarahisar Health Sciences University, Faculty of Medicine, Afyonkarahisar, Turkey
,
Mehmet G. Boyacı 
1   Department of Neurosurgery, Afyonkarahisar Health Sciences University, Faculty of Medicine, Afyonkarahisar, Turkey
,
Akın Cengiz 
1   Department of Neurosurgery, Afyonkarahisar Health Sciences University, Faculty of Medicine, Afyonkarahisar, Turkey
,
Adem Aslan    *
1   Department of Neurosurgery, Afyonkarahisar Health Sciences University, Faculty of Medicine, Afyonkarahisar, Turkey
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Abstract

Magnetic resonance imaging (MRI) can be used to examine tethered cord syndrome (TCS) and terminal syringomyelia (TS). Additionally, there is increasing evidence of an association between congenital anomalies and TCS. We aimed to identify the clinical and radiological characteristics of syringomyelia and other anomalies in pediatric and adult patients with TCS. This study included 54 TCS patients (mean age, 17.37 ± 15.83 years; 31 females) admitted to our department between 2010 and 2019. The patients were divided into two age groups: pediatric (<18 years; 63%) and adult (>18 years). Clinical findings, direct vertebrae radiographs, lower extremity radiographs, and spinal/cranial MRI findings were used to evaluate all patients. Computed tomography (CT) was performed to reveal the structure of the septum in patients with Diastematomyelia. Cranial ultrasonography or CT was performed if the fontanel was open or closed, respectively, in pediatric hydrocephalus cases. Pelvic ultrasonography and urodynamic tests were performed to evaluate other comorbid anomalies and urinary system pathologies. A thick filum terminale (73.3%) and diastematomyelia (44.4%) were found to cause spinal tension. The most common accompanying pathology was syringomyelia (78%). The common symptoms were urinary incontinence and bowel problems (71%), scoliosis (68%), and progressive lower extremity weakness (64.4%). It is difficult to distinguish the exact cause of symptoms in patients with TCS and TS. Due to the greater occurrence of other congenital spinal anomalies accompanying TCS, both preoperative symptoms and clinical findings are more severe in the pediatric group than in the adult group, and postoperative results may be more negative.

Keywords

tethered cord - syringomyelia - diastematomyelia - scoliosis - congenital anomalies - pediatric patients - magnetic resonance imaging

Ethics Consideration

Approval for this study dated June 11, 2020, and numbered 2020/486 (2011-KAEK-2) was obtained from Afyonkarahisar University of Health Sciences Local Ethics Committee.


# Contributed equally to the present study.


* Senior author.




Publication History

Received: 26 May 2022

Accepted: 26 June 2022

Article published online:
19 September 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Georg Thieme Verlag KG
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