A. Henry et al., TETHERED THORACIC CORD RESULTING FROM SPINAL-CORD HERNIATION, Archives of physical medicine and rehabilitation, 78(5), 1997, pp. 530-533
Tethered cord syndrome (TCS) usually involves tethering of the lower c
ord at the conus medullaris from dural abnormalities, but may occur af
ter spinal cord herniation. A tethered thoracic spinal cord is rare, W
e present an unusual case of a 30-year-old woman with a history of mye
lopathy presumed to be secondary to T6 cord compression resulting from
T6-T8 arachnoid cyst. She continued to deteriorate after partial exci
sion of the cyst. Repeat magnetic resonance imaging suggested recurren
ce of the presumed arachnoid cyst with cord compression and showed tet
hering at TG-Tg. Surgical exploration revealed myelocele with cord her
niation through the anterior thoracic dura. Pathologic diagnosis showe
d neural tissue with gliosis. After physical therapy treatments, the p
atient]lad increased lower extremity strength, ambulated with a cane,
and regained some bladder control. Progressive myelopathy map represen
t tethering of the cord resulting from cord herniation. Early recognit
ion of TCS, even in patients with minimal neurologic deficits, could p
revent progressive disability. (C) 1997 by the American Congress of Re
habilitation Medicine and the American Academy of Physical Medicine an
d Rehabilitation.