Yu Zhang1, Bing Xia1, Fuyun Liu2, Xueqiang Niu1, Weiming Hu1, Huiling Wu1. 1. Department of Pediatric Orthopaedics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China. 2. Department of Pediatric Orthopaedics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou, China. liufuyun111@126.com.
Abstract
INTRODUCTION: Tethered cord syndrome (TCS) is the progressive development of various neuromuscular dysfunctions caused by the traction of the conus medullaris resulting from congenital or acquired causes, which are often accompanied by fecal and/or urinary incontinence and abnormal sensory motor functions of lower limbs. Lower back pain is a common clinical symptom of TCS patients and can be significantly improved by surgical untethering. However, the specific relationship between the increase in lumbosacral angle and TCS has rarely been reported. PATIENT: A case of TCS in an 8-year-old girl is reported. The patient had lower back pain complicated by increased lumbosacral angle for more than 20 days. DIAGNOSES: Physical examination and MRI results showed that the condition of the child has been complicated by TCS. INTERVENTIONS: After additional relevant examination, surgical untethering of the terminal filum was performed under general anesthesia. OUTCOMES: The symptoms of lower back pain disappeared, and the plain radiographs indicated that the lumbosacral angle decreased and lumbar lordosis returned to normal. During the follow-up period of half a year, the child did not experience particular discomfort or asymptomatic aggravation. CONCLUSIONS: For children with low back pain complicated by lumbosacral angle increase, MRI should be performed to exclude TCS. Once the patient has been diagnosed, early surgical treatment should be provided.
INTRODUCTION: Tethered cord syndrome (TCS) is the progressive development of various neuromuscular dysfunctions caused by the traction of the conus medullaris resulting from congenital or acquired causes, which are often accompanied by fecal and/or urinary incontinence and abnormal sensory motor functions of lower limbs. Lower back pain is a common clinical symptom of TCS patients and can be significantly improved by surgical untethering. However, the specific relationship between the increase in lumbosacral angle and TCS has rarely been reported. PATIENT: A case of TCS in an 8-year-old girl is reported. The patient had lower back pain complicated by increased lumbosacral angle for more than 20 days. DIAGNOSES: Physical examination and MRI results showed that the condition of the child has been complicated by TCS. INTERVENTIONS: After additional relevant examination, surgical untethering of the terminal filum was performed under general anesthesia. OUTCOMES: The symptoms of lower back pain disappeared, and the plain radiographs indicated that the lumbosacral angle decreased and lumbar lordosis returned to normal. During the follow-up period of half a year, the child did not experience particular discomfort or asymptomatic aggravation. CONCLUSIONS: For children with low back pain complicated by lumbosacral angle increase, MRI should be performed to exclude TCS. Once the patient has been diagnosed, early surgical treatment should be provided.
Entities:
Keywords:
Lower back pain; MRI; Tethered cord syndrome
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