David J Hart1, Ronald I Apfelbaum. 1. Department of Neurological Surgery, Los Angeles County and University of Southern California, Los Angeles, California, USA. david.hart@uhhs.com
Abstract
OBJECTIVE AND IMPORTANCE: This is the first reported case of anterior cervical spinal cord tethering after anterior spinal surgery. A mechanistic hypothesis is presented to explain the observed phenomenon. CLINICAL PRESENTATION: A patient developed cervical myelopathy 2 years after multiple anterior cervical discectomies complicated by cerebrospinal fluid leakage. She demonstrated reflex and motor changes as well as neuropathic pain. INTERVENTION: An anterior corpectomy was performed, with opening of the dura and detethering of an arachnoid band and then fusion and plating. CONCLUSION: Reflex and motor changes improved, but pain did not. We hypothesize that mechanical deformation and scar formation after cerebrospinal fluid leakage may have led to tethering of the spinal cord.
OBJECTIVE AND IMPORTANCE: This is the first reported case of anterior cervical spinal cord tethering after anterior spinal surgery. A mechanistic hypothesis is presented to explain the observed phenomenon. CLINICAL PRESENTATION: A patient developed cervical myelopathy 2 years after multiple anterior cervical discectomies complicated by cerebrospinal fluid leakage. She demonstrated reflex and motor changes as well as neuropathic pain. INTERVENTION: An anterior corpectomy was performed, with opening of the dura and detethering of an arachnoid band and then fusion and plating. CONCLUSION: Reflex and motor changes improved, but pain did not. We hypothesize that mechanical deformation and scar formation after cerebrospinal fluid leakage may have led to tethering of the spinal cord.
Authors: Vinod Kumar Tewari; Rituj Somvanshi; Ravindra Bihari Trivedi; Mazhar Hussain; H K Das Gupta; R S Dubey Journal: Asian J Neurosurg Date: 2018 Jan-Mar