Tethered cord syndrome

Question 1

Tethered cord syndrome def radiologically 📻

Answer 1

Low conus medullaris below L2 + short thickens filum terminal > 2 mm +/- intradural lipoma
MCC MM might be clinical or radiological only

Question 2

Normal consus end at

Answer 2

L2

Question 3

Presentation of Tethered cord syndrome

Answer 3

Question 4

MM in Tethered cord syndrome

Answer 4

⬆️⬆️ scoliosis , spasticity,gaite, urodynamci
🚨r/ or shunt malfunction
😭🚨 painfull tethered cords until proven otherwise
☺️ painless syringomyelia until proven otherwise

Question 5

Scoliosis in tethered cord

Answer 5

Early untether will improve scoliosis
If degree 10 will have improvement
If degree > 50 will deteriorate

Question 6

Tether in 👨 vs 👦

Answer 6

Question 7

Normal diameter of filum

Answer 7

1 mm

Question 8

low lying conus

Answer 8

Not below ⬇️ L3 , normal diameter vs
Tether low below L2 and diameter > 2 mm

Question 9

Pre operative Tether cord

Answer 9

cystometrogram

Question 10

Post operative changes bladder function due to

Answer 10

stretching of the lower fibers of the cauda equina).

Question 11

Surgical TC

Answer 11

Laminectomy , if lipoma resection ,separate filum

Question 12

Intra op 🔺 filum. And nerve root

Answer 12

Filum ➡️ squiggly vesse, white , ligamentous-like
Nerve

Question 13

Tether cord outcome 👦 vs 👨

Answer 13

🧒 impossible prematurely untether In growing MM child may need 2-4 detethring
Csf leak 15
👨 pain improve , but b
Adder return poor