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Question: Neuro
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Kelly March 17, 2021 - 11:07 pm
A) Back pain is a common presenting symptom
Tethered cord syndrome refers to progressive dysfunction due to an abnormal fixation of the spinal cord to the vertebral column. It is commonly associated with spina bifida occulta, but can occur with other conditions as well, and cutaneous dorsal spinal stigmata such as sacral dimples, hair tufts, hypertrichosis, hemangiomas, lipomas, and dermal sinus tracts are present in the majority but not all patients. Motor deficits are more common than sensory. Other findings include gait abnormalities, hypotonia, abnormal reflexes, not meeting developmental motor milestones, bowel/bladder incontinence. It can present in adolescents and adults, and they frequently complain of lumbosacral back pain, often associated with shock-like feeling to the lower extremities. Ultrasonography can screen for spinal dysraphism in < 3 month olds, but after 3 months of age vertebral ossification makes US less useful. MRI is the gold standard test.