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  • Title: Reduction of caudal traction force using dural sac opening rather than spinal cord detethering for tethered cord syndrome caused by lipomyelomeningocele: a case report.
    Author: Murata Y, Kanaya K, Wada H, Wada K, Shiba M, Kato Y.
    Journal: Spine J; 2014 Oct 01; 14(10):e1-3. PubMed ID: 24613376.
    Abstract:
    BACKGROUND CONTEXT: A few reports have addressed tethered cord syndrome. Detethering surgery has been performed in these cases because abnormal tension on the spinal cord causes neurologic and urologic symptoms. PURPOSE: To discuss the surgical treatment of tethered cord syndrome with the belief that the tension on the cord can be decreased by shifting tethered cord to the dorsal side. STUDY DESIGN: A patient with tethered cord syndrome was surgically treated by shifting the tethered cord to the dorsal side by harnessing the lumbar lordosis instead of detethering. METHODS: We performed surgery to shift the tethered cord to the dorsal side by harnessing the lumbar lordosis to decrease the tension on the spinal cord. RESULTS: The tethered cord that was pressed to the ventral side because of a lipoma was shifted dorsally by laminectomy and opening of the dural sac. Pain and numbness were alleviated immediately after surgery. CONCLUSIONS: The method used in the present case, that is, shifting the tethered cord and lipoma to the dorsal side by harnessing the lumbar lordosis instead of detethering, is a viable treatment option for tethered cord syndrome.
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