471:. In most people the spine grows faster than the spinal cord during development which causes the end of the spinal cord to appear to rise relative to the bony spine next to it. By the time of birth the spinal cord is located between L1 and L2. In a baby with Spina bifida the spinal cord is still attached to the skin around it preventing it from rising properly. This occurs because the spinal cord in a child with Spina bifida is low lying and tethered at the bottom. At the time of birth the mylomeningocele is separated from the skin but the spinal cord is still stuck in the same place. As the child begins to grow the spinal cord remains in the same place becoming stretched out causing the tight cord and the tethering at the end. With this type of tethering there is an interference with the blood supply to the nerves and body which can then cause the deterioration of the body causing orthopedic, neurological, and urological problems. With milder forms of Spina bifida such as Occulta, may be related to the degree of strain on the cord which can become worse with physical activity, injury, pregnancy, bone spurs, or
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susceptibility to hypoxic stress to the lumbar and sacral portion of the spinal cord under traction with various weights. Similar effects were found in redox behavior of tethered spinal cord during the surgical procedures to repair it. This can be due to impairment of mitochondrial oxidative metabolism under constant or intermittent stretching. The act of prolonged stretching can lead to structural damage to the neural perikarya and eventually the axons in neurons. The untethering process can improve the oxidative metabolism and can help to repair injured neurons.
555:. A vertebral osteotomy aims to indirectly relieve the excess tension on the spinal cord by removing a portion of the spine, shortening it. This procedure offers a unique benefit in that the spinal cord remains fixated to the spine, preventing retethering and spinal cord injury as possible surgical complications. However, its complexity and limited “track record” presently keeps vertebral osteotomies reserved as an option for patients who have failed in preventing retethering after detethering procedure(s).
585:, neck and upper back problems and bladder control issues. Surgery on adults with minimal symptoms is somewhat controversial. For example, a website from the Columbia University Department of Neurosurgery says, "For the child that has reached adult height with minimal if any symptoms, some neurosurgeons would advocate careful observation only." However, surgery for those who have worsening symptoms is less controversial. If the only abnormality is a thickened, shortened filum, then a limited lumbosacral
25:
318:, and pathologic plantar response, occurring in the same limb. Profound sensory changes, such as loss of pain, temperature, and proprioceptive sensations, are common. Last, progressive symptoms of a neuropathic bladder are noted on over 70% of adult patients, versus only 20% to 30% of children. These symptoms include urinary frequency and urgency, feeling of incomplete voiding, poor voluntary control,
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rather than make the diagnosis. MRI has revolutionized the noninvasive evaluation of spinal cord lesions. The major obstacle to obtaining an MRI in children is the need for sedation or general anesthesia. Patients with tethered cord have displacement of the conus and elongation of the cord, with a
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The disorder progresses with age, but the aforementioned treatments can help prevent or sometimes relieve symptoms. With treatment, individuals with tethered spinal cord syndrome have a normal life expectancy. Studies have shown surgery can help improve low back pain, urinary symptoms leg weakness
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cord. The spinal cord normally hangs loose in the canal, free to move up and down with growth, and with bending and stretching. A tethered cord, however, is held taut at the end or at some point in the spinal canal. In children, a tethered cord can force the spinal cord to stretch as they grow. In
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TCS, however, is a clinical diagnosis that should be based on "neurological and musculoskeletal signs and symptoms. Imaging features are in general obtained to support rather than make the diagnosis." This is especially true for cases of occult tethered cord, where the patient has the symptoms of
450:
Tethered spinal cord is a disorder and not a mechanism so it does not spread to other people and there are no measures that can be done to prevent it beforehand. The only preventative measure that is successful is to surgically untether the spinal cord though there might already be irreversible
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In the mid- and late 1980s, magnetic resonance imaging (MRI) developed to a degree that allowed visualization of the spinal anatomy without the use of x-radiation or subarachnoid injection of contrast agents. It has emerged as the most useful noninvasive modality, providing excellent detail of
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In adults, surgery to detether (free) the spinal cord can reduce the size and further development of cysts in the cord and may restore some function or alleviate other symptoms. Although detethering is the common surgical approach to TCS, another surgical option for adults is a spine-shortening
500:
In order to understand the pathophysiology that is involved in a tethered spinal cord, the reduction/oxidation ratio has to be used in vivo of cytochrome alpha and alpha 3 to signal the oxidative metabolic functioning in humans. Studies have found that marked metabolic and electrophysiological
395:
Tethered spinal cord can be caused by various conditions but the main cause is when tissue attachments limit the movement of the spinal cord in the spinal column which causes abnormal stretching of the cord. The tethered spinal cord syndrome is correlated with having the causes:
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Because neurological deficits are generally irreversible, early surgery is recommended when symptoms begin to worsen. In children, early surgery is recommended to prevent further neurological deterioration, including but not limited to chronic urinary incontinence.
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This syndrome was first noticed in the late 19th century. While information has been available for years, little widespread blind research has been done. More research has been called for, and doctors have conducted many studies with good results. There is a low
597:, and no complications have been documented other than those typical of any type of back surgery. The association of this condition with others has been noticed, and needs further research to understand such relationships. TCS is causally linked to
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Tethered spinal cord syndrome may go undiagnosed until adulthood, when sensory, motor, bowel, and bladder control issues emerge. This delayed presentation of symptoms relates to the degree of strain on the spinal cord over time.
530:). After about 3 months of age, a conus below the L1-2 disk space may indicate a tethered cord and termination below L3-4 is unmistakably tethered. "Cord tethering is often assumed when the conus is below the normal L2-3 level.
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609:, which should also be screened for upon a positive TCS diagnosis. Spinal compression and the resulting relief is a known issue with this disorder. Like with the early-onset form, this disease form is linked to the
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anatomy and characterization of soft tissue anomalies. ... MRI has become the primary imaging modality for tethered cords and has both facilitated earlier diagnosis and tailored treatment of these disorders.
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Tethering may also develop after spinal cord injury. Scar tissue can block the flow of fluids around the spinal cord. Fluid pressure may cause cysts to form in the spinal cord, a condition called
1816:
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tethered cord syndrome but MRI reveals the conus to be above the L2 level. Clinical evaluation may include a simple rectal examination and may also include invasive or non-invasive
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adults the spinal cord stretches in the course of normal activity, usually leading to progressive spinal cord damage if untreated. TCS is often associated with the closure of a
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Urodynamic testing has emerged as the quintessential evaluation to explicitly identify, document, and quantify the effects of neurological dysfunction on the urinary system.
1400:
Kokubun, S.; Ozawa, H.; Aizawa, T.; Ly, N. M.; Tanaka, Y (July 2011). "Spine-shortening osteotomy for patients with tethered cord syndrome caused by lipomyelomeningocele".
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Miyakoshi, N.; Abe, E.; Suzuki, T.; Kido, T.; Chiba, M.; Shimada, Y. (2009). "Spine-shortening vertebral osteotomy for tethered cord syndrome: report of three cases".
475:. The tethered cord in this case might not be diagnosed until adulthood when it worsens and can still cause neurological, orthopedic, and urological dysfunctions.
574:
combined with anti-seizure compounds have yet to prove they are of value in treatment of this affliction's pain manifestations. There is anecdotal evidence that
667:
839:"Patient-Reported Outcomes Following Sectioning of the Filum Terminale for Treatment of Tethered Cord Syndrome Associated With Ehlers-Danlos Syndrome"
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After the patient reaches 5 years of age, it becomes increasingly difficult to image the thoracic spinal cord to adequately evaluate pulsations.
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The diagnosis of TCS is primarily based on neurological and musculoskeletal signs and symptoms. Imaging features are in general obtained to
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538:. "Bladder dysfunction occurs in ~40% of patients affected by tethered cord syndrome. ... t may be the earliest sign of the syndrome."
61:
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Wehby MC, O'Hollaren PS, Abtin K, Hume JL, Richards BJ (2004). "Occult tight filum terminale syndrome: results of surgical untethering".
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948:
68:
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2015:
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Khoury, Antoine E. (2010). "Clinical
Experience in Urological Involvement with Tethered Cord Syndrome". In Yamada, Shokei (ed.).
526:(or lower termination of the spinal cord) normally terminates at or above the L1-2 disk space (where L1 is the first, or topmost
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and any affirmative diagnosis of TCS must be followed by screening for Chiari's several degrees. TCS may also be related to
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Treatment may be needed in adults who, while previously asymptomatic, begin to experience pain, lower back degeneration,
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322:, and urge and stress incontinence. Chronic recurrent infections are common and occasionally lead to nephrolithiasis (
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Tethered spinal cord syndrome is a clinical entity which is manifested by progressive motor and sensory changes in:
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Hadley, H. Roger (2010). "Lower
Urinary Tract Dysfunction in Tethered Cord Syndrome". In Yamada, Shokei (ed.).
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Hadley, H. Roger (2010). "Lower
Urinary Tract Dysfunction in Tethered Cord Syndrome". In Yamada, Shokei (ed.).
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For children younger than eight weeks of age (and possibly in utero), a tethered cord may be observed using
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Nelson, Jr., Marvin D. (2010). "Ultrasonic
Evaluation of Tethered Cord Syndrome". In Yamada, Shokei (ed.).
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Sanford
Schneider (2009). "Neurological Assessment of Tethered Spinal Cord". In Yamada, Shokei (ed.).
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Neurological symptoms can include a mixed picture of upper and lower motor neuron findings, such as
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Yamada, S.; Zinke, D. E.; Sanders, D. (April 1981). "Pathophysiology of "tethered cord syndrome"".
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197:. It can be congenital, such as in tight filum terminale, or the result of injury later in life.
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188:. All forms involve the pulling of the spinal cord at the base of the spinal canal, literally a
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Hinshaw Jr., David B. (2010). "Imaging of
Tethered Spinal Cord". In Yamada, Shokei (ed.).
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725:"Tethered Spinal Cord Syndrome | National Institute of Neurological Disorders and Stroke"
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and walking distance. However, most neurological and motor impairments are irreversible.
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Nelson, Jr., Stephen L. (6 October 2013). "Clinical
Summary: Tethered Spinal Cord".
749:"Syringomyelia Fact Sheet | National Institute of Neurological Disorders and Stroke"
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267:. This can lead to additional loss of movement or feeling, or the onset of pain or
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Wehby, M. C.; O'Hollaren, P. S.; Abtin, K.; Hume, J. L.; Richards, B. J. (2004).
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Zingman, Alissa; Tuchman, Kelly; Henderson, Fraser; Francomano, Clair A. (2022).
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467:. Tethering of the spinal cord tends to occur in the cases of Spina bifida with
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Severe pain (in the lower back and radiating into the legs, groin, and perineum)
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513:. Ultrasonography may still be useful through age 5 in limited circumstances.
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890:"Tethered Cord as a Complication of Chronic Cerebral Spinal Fluid Diversion"
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including awkwardness while running or wearing the tips or side of one shoe
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can be accompanied by tethering of the spinal cord but in rare cases with
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212:, hairy patches, dimples, hemangiomas, or fatty tumours on the lower back
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1639:"Occult Tight Filum terminale Syndrome: Results of Surgical Untethering"
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imaging appears to be the gold standard for diagnosing a tethered cord.
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976:"Spinal Cord Tethering A common cause of deterioration in Spina Bilda"
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with division of the filum may be sufficient to relieve the symptoms.
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Agarwal, Nitin; Hansberry, David R.; Goldstein, Ira M. (2017-08-04).
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613:, in which the brain is pulled or lowers into the top of the spine.
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Other treatment is symptomatic and supportive. Medications such as
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334:. Female patients also give a history of ineffective labor and
209:
1300:(Rev. ed.). Thieme Medical Publishers, Inc. p. 47.
1272:(Rev. ed.). Thieme Medical Publishers, Inc. p. 77.
1198:(Rev. ed.). Thieme Medical Publishers, Inc. p. 90.
1169:(Rev. ed.). Thieme Medical Publishers, Inc. p. 51.
1126:(Rev. ed.). Thieme Medical Publishers, Inc. p. 72.
342:
1636:
1548:
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Shih, P.; Halpin, R.; Ganju, A.; Liu, J.; Koski, T. (2010).
1229:"Pediatric urodynamics: basic concepts for the neurosurgeon"
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1594:"Tethered cord syndrome and the conus in a normal position"
232:
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A tethered cord is often diagnosed as a "low conus". The
228:
Weakness in the legs (loss of muscle strength and tone)
1480:"Management of Recurrent Adult Tethered Cord Syndrome"
1434:
244:(abnormal curvature of the spine to the left or right)
1226:
703:(Rev. ed.). Thieme Medical Publishers, Inc. 44.
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1399:
1337:"Congenital tethered spinal cord syndrome in adults"
1335:
Iskandar BJ, Fulmer BB, Hadley MN, Oakes WJ (2001).
220:
Skin manifestation typical of tethered cord syndrome
802:
800:
49:. Unsourced material may be challenged and removed.
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1215:sometimes thickened or fatty density in the filum.
1078:
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649:", Columbia University Department of Neurosurgery.
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284:Loss of feeling and movement in lower extremities
2790:
797:
274:In adults, onset of symptoms typically include:
780:, Treasure Island (FL): StatPearls Publishing,
1032:Yamada, S.; Zinke, D. E.; Sanders, D. (1981).
772:Emos, Marc Christopher; Rosner, Julie (2022),
2110:
1824:
1298:Tethered Cord Syndrome in Children and Adults
1270:Tethered Cord Syndrome in Children and Adults
1196:Tethered Cord Syndrome in Children and Adults
1167:Tethered Cord Syndrome in Children and Adults
1124:Tethered Cord Syndrome in Children and Adults
1034:"Pathophysiology of "tethered cord syndrome""
832:
830:
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701:Tethered Cord Syndrome in Children and Adults
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1227:Kitchens DM, Herndon CD, Joseph DB (2007).
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771:
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639:
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570:, and off-label applications of tricyclic
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864:
854:
109:Learn how and when to remove this message
1289:
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2016:Bilateral frontoparietal polymicrogyria
774:"Neuroanatomy, Upper Motor Nerve Signs"
681:
632:
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894:International Journal of Spine Surgery
660:"Tethered Cord Syndrome - an overview"
281:Bilateral muscle weakness and numbness
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1812:
1395:
1393:
970:
968:
808:"Recurrence of symptoms post-surgery"
200:
2638:Greig cephalopolysyndactyly syndrome
1592:Warder, D. E.; Oakes, W. J. (1993).
946:
348:
164:that relate to malformations of the
47:adding citations to reliable sources
18:
205:In children, symptoms may include:
13:
2128:malformations and deformations of
1842:malformations and deformations of
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965:
14:
2810:
1804:National institute of Health page
1732:
1712:"Facts on Tethered Cord Syndrome"
135:Occult spinal dysraphism sequence
1610:10.1227/00006123-199309000-00004
23:
2311:Congenital patellar dislocation
2190:Wallis–Zieff–Goldblatt syndrome
1968:Agenesis of the corpus callosum
1704:
1692:"Tethered spinal cord syndrome"
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1630:
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1379:. National Institutes of Health
1377:"Tethered spinal cord syndrome"
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1328:
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1014:from the original on 2022-11-28
996:
949:"Tethered Spinal Cord Syndrome"
940:
670:from the original on 2022-11-28
454:
58:"Tethered spinal cord syndrome"
34:needs additional citations for
1402:Journal of Neurosurgery: Spine
881:
765:
741:
717:
652:
459:In tethered spinal cord cases
168:. Various forms include tight
1:
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422:Tumor(s) in the spinal column
127:Tethered spinal cord syndrome
1449:10.1097/BRS.0b013e3181af2607
1004:"Spina Bifida - an overview"
616:
541:
504:
478:
176:, split cord malformations (
7:
2597:Oto-palato-digital syndrome
2592:Hallermann–Streiff syndrome
2316:Congenital knee dislocation
2134:musculoskeletal abnormality
1934:other reduction deformities
812:Chiari Online Support Group
578:may benefit some patients.
225:Foot and spinal deformities
10:
2815:
2628:Craniodiaphyseal dysplasia
1649:(2): 51–7, discussion 58.
1557:(2): 51–7, discussion 58.
1093:10.3171/jns.1981.54.4.0494
1050:10.3171/jns.1981.54.4.0494
611:Arnold–Chiari malformation
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2602:Treacher Collins syndrome
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419:History of spinal surgery
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126:
2427:Cenani–Lenz syndactylism
2180:Cleidocranial dysostosis
1920:Congenital hydrocephalus
1497:10.3171/2010.3.FOCUS1073
1322:"TETHERED CORD SYNDROME"
983:Spina Bifida Association
434:(s) in the spinal column
416:History of spinal trauma
390:
287:Urinary irregularities (
269:autonomic nervous system
247:Urinary irregularities (
2574:Craniofacial dysostosis
1354:10.3171/foc.2001.10.1.8
1081:Journal of Neurosurgery
1038:Journal of Neurosurgery
425:Thickened and/or tight
341:, presumably due to an
160:) refers to a group of
2130:musculoskeletal system
1643:Pediatric Neurosurgery
1551:Pediatric Neurosurgery
603:Ehlers–Danlos syndrome
536:urological examination
440:(congenital deformity)
375:Ehlers-Danlos syndrome
332:kidney transplantation
231:Change in or abnormal
221:
162:neurological disorders
154:Tethered cord syndrome
16:Neurological disorders
2799:Spinal cord disorders
2682:Klippel–Feil syndrome
1973:Septo-optic dysplasia
1925:Dandy–Walker syndrome
1528:"Adult Tethered Cord"
607:Klippel–Feil syndrome
566:, synthetic opiates,
380:Klippel-Feil syndrome
219:
2692:Spina bifida occulta
2208:Madelung's deformity
2185:Sprengel's deformity
1246:10.3171/FOC-07/08/E8
1008:ScienceDirect Topics
856:10.7759/cureus.24679
664:ScienceDirect Topics
647:Tethered Spinal Cord
465:Spina bifida occulta
298:Bowel control issues
174:lipomeningomyelocele
43:improve this article
2510:RAPADILINO syndrome
1899:Chiari malformation
1690:Fitzgerald, Kevin.
1484:Neurosurgical Focus
1341:Neurosurgical Focus
599:Chiari malformation
446:(split spinal cord)
182:dermal sinus tracts
2372:Rocker bottom foot
2070:Currarino syndrome
2041:Neural tube defect
1983:Hemimegalencephaly
1949:Microlissencephaly
1861:Neural tube defect
438:Dermal Sinus Tract
222:
201:Signs and symptoms
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2707:Thoracic skeleton
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1939:Holoprosencephaly
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1563:10.1159/000078908
1443:(22): E823–E825.
1307:978-1-60406-241-0
1279:978-1-60406-241-0
1205:978-1-60406-241-0
1176:978-1-60406-241-0
1133:978-1-60406-241-0
753:www.ninds.nih.gov
729:www.ninds.nih.gov
710:978-1-60406-241-0
349:Related disorders
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121:Medical condition
119:
118:
111:
93:
2806:
2754:Pectus carinatum
2749:Pectus excavatum
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2670:Spinal curvature
2662:Vertebral column
2582:Crouzon syndrome
2546:Craniosynostosis
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2263:Upington disease
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1367:
1366:
1356:
1332:
1326:
1325:
1318:
1312:
1311:
1293:
1287:
1286:
1265:
1259:
1258:
1248:
1224:
1218:
1217:
1191:
1185:
1184:
1162:
1156:
1155:
1147:
1141:
1140:
1119:
1113:
1112:
1076:
1070:
1069:
1029:
1023:
1022:
1020:
1019:
1000:
994:
993:
991:
985:. Archived from
980:
972:
963:
962:
960:
959:
947:Zalatimo, Omar.
944:
938:
937:
927:
909:
885:
879:
878:
868:
858:
834:
823:
822:
820:
819:
804:
795:
794:
793:
792:
769:
763:
762:
760:
759:
745:
739:
738:
736:
735:
721:
715:
714:
696:
679:
678:
676:
675:
656:
650:
643:
568:COX-2 inhibitors
524:conus medullaris
493:back of leg pain
444:Diastematomyelia
365:Brain herniation
178:diastematomyelia
124:
123:
114:
107:
103:
100:
94:
92:
51:
27:
19:
2814:
2813:
2809:
2808:
2807:
2805:
2804:
2803:
2789:
2788:
2787:
2774:
2770:Poland syndrome
2758:
2734:
2701:
2652:
2606:
2568:
2514:
2505:Larsen syndrome
2493:multiple joints
2488:
2448:
2381:
2320:
2301:Genu recurvatum
2277:
2254:Hip dislocation
2227:
2194:
2144:
2136:
2123:
2093:
2084:
2058:
2022:
1959:Hydranencephaly
1903:
1846:
1837:
1800:
1795:
1794:
1749:
1735:
1730:
1729:
1720:
1718:
1710:
1709:
1705:
1688:
1684:
1675:
1673:
1635:
1631:
1622:
1620:
1590:
1586:
1547:
1543:
1533:
1531:
1526:
1525:
1521:
1476:
1472:
1433:
1429:
1398:
1391:
1382:
1380:
1375:
1374:
1370:
1333:
1329:
1320:
1319:
1315:
1308:
1294:
1290:
1280:
1266:
1262:
1233:Neurosurg Focus
1225:
1221:
1206:
1192:
1188:
1177:
1163:
1159:
1148:
1144:
1134:
1120:
1116:
1077:
1073:
1030:
1026:
1017:
1015:
1002:
1001:
997:
992:on Aug 4, 2016.
989:
978:
974:
973:
966:
957:
955:
945:
941:
886:
882:
835:
826:
817:
815:
814:. 6 August 2013
806:
805:
798:
790:
788:
770:
766:
757:
755:
747:
746:
742:
733:
731:
723:
722:
718:
711:
697:
682:
673:
671:
658:
657:
653:
644:
633:
628:
619:
572:antidepressants
544:
528:lumbar vertebra
511:ultrasonography
507:
481:
473:spinal stenosis
469:mylomeningocele
457:
427:filum terminale
408:Mylomeningocele
393:
351:
339:rectal prolapse
203:
170:filum terminale
122:
115:
104:
98:
95:
52:
50:
40:
28:
17:
12:
11:
5:
2812:
2802:
2801:
2784:
2783:
2780:
2779:
2776:
2775:
2773:
2772:
2766:
2764:
2760:
2759:
2757:
2756:
2751:
2745:
2743:
2736:
2735:
2733:
2732:
2727:
2721:
2719:
2709:
2703:
2702:
2700:
2699:
2694:
2689:
2684:
2679:
2678:
2677:
2666:
2664:
2658:
2657:
2654:
2653:
2651:
2650:
2645:
2640:
2635:
2633:Dolichocephaly
2630:
2625:
2620:
2614:
2612:
2608:
2607:
2605:
2604:
2599:
2594:
2589:
2584:
2578:
2576:
2570:
2569:
2567:
2566:
2564:Trigonocephaly
2561:
2556:
2550:
2548:
2539:
2537:Skull and face
2530:
2524:
2523:
2520:
2519:
2516:
2515:
2513:
2512:
2507:
2502:
2500:Arthrogryposis
2496:
2494:
2490:
2489:
2487:
2486:
2485:
2484:
2479:
2474:
2462:
2456:
2454:
2450:
2449:
2447:
2446:
2445:
2444:
2434:
2429:
2424:
2422:Arachnodactyly
2419:
2418:
2417:
2402:
2400:
2391:
2387:
2386:
2383:
2382:
2380:
2379:
2374:
2369:
2364:
2363:
2362:
2350:
2349:
2348:
2343:
2330:
2328:
2326:foot deformity
2322:
2321:
2319:
2318:
2313:
2308:
2303:
2298:
2293:
2287:
2285:
2279:
2278:
2276:
2275:
2270:
2265:
2260:
2250:
2248:
2239:
2233:
2232:
2229:
2228:
2226:
2225:
2220:
2215:
2210:
2204:
2202:
2200:hand deformity
2196:
2195:
2193:
2192:
2187:
2182:
2176:
2174:
2161:
2152:
2138:
2137:
2122:
2121:
2114:
2107:
2099:
2090:
2089:
2086:
2085:
2083:
2082:
2077:
2072:
2066:
2064:
2060:
2059:
2057:
2056:
2051:
2045:
2043:
2034:
2028:
2027:
2024:
2023:
2021:
2020:
2019:
2018:
2011:Polymicrogyria
2007:
2006:
2005:
2004:
2002:Schizencephaly
1999:
1986:
1985:
1980:
1978:Megalencephaly
1975:
1970:
1964:
1963:
1962:
1961:
1956:
1951:
1946:
1941:
1930:
1929:
1928:
1927:
1917:
1911:
1909:
1905:
1904:
1902:
1901:
1896:
1891:
1890:
1889:
1884:
1879:
1874:
1865:
1863:
1854:
1848:
1847:
1844:nervous system
1836:
1835:
1828:
1821:
1813:
1807:
1806:
1797:
1796:
1793:
1792:
1781:
1766:
1750:
1745:
1744:
1742:
1741:Classification
1734:
1733:External links
1731:
1728:
1727:
1703:
1682:
1629:
1604:(3): 374–378.
1584:
1541:
1519:
1470:
1427:
1389:
1368:
1327:
1313:
1306:
1288:
1278:
1260:
1219:
1204:
1186:
1175:
1157:
1142:
1132:
1114:
1087:(4): 494–503.
1071:
1044:(4): 494–503.
1024:
995:
964:
939:
880:
824:
796:
764:
740:
716:
709:
680:
651:
630:
629:
627:
624:
618:
615:
595:morbidity rate
543:
540:
506:
503:
498:
497:
494:
491:
488:
480:
477:
456:
453:
448:
447:
441:
435:
429:
423:
420:
417:
414:
413:
412:
409:
406:
392:
389:
388:
387:
382:
377:
372:
367:
362:
357:
350:
347:
345:pelvic floor.
328:kidney failure
300:
299:
296:
285:
282:
279:
257:
256:
245:
239:
236:
229:
226:
214:
213:
202:
199:
149:
148:
143:
137:
136:
133:
129:
128:
120:
117:
116:
31:
29:
22:
15:
9:
6:
4:
3:
2:
2811:
2800:
2797:
2796:
2794:
2771:
2768:
2767:
2765:
2761:
2755:
2752:
2750:
2747:
2746:
2744:
2741:
2737:
2731:
2728:
2726:
2723:
2722:
2720:
2717:
2713:
2710:
2708:
2704:
2698:
2697:Sacralization
2695:
2693:
2690:
2688:
2685:
2683:
2680:
2676:
2673:
2672:
2671:
2668:
2667:
2665:
2663:
2659:
2649:
2646:
2644:
2643:Plagiocephaly
2641:
2639:
2636:
2634:
2631:
2629:
2626:
2624:
2621:
2619:
2616:
2615:
2613:
2609:
2603:
2600:
2598:
2595:
2593:
2590:
2588:
2587:Hypertelorism
2585:
2583:
2580:
2579:
2577:
2575:
2571:
2565:
2562:
2560:
2557:
2555:
2554:Scaphocephaly
2552:
2551:
2549:
2547:
2543:
2540:
2538:
2534:
2531:
2529:
2525:
2511:
2508:
2506:
2503:
2501:
2498:
2497:
2495:
2491:
2483:
2480:
2478:
2475:
2473:
2470:
2469:
2468:
2467:
2463:
2461:
2458:
2457:
2455:
2451:
2443:
2440:
2439:
2438:
2437:Brachydactyly
2435:
2433:
2430:
2428:
2425:
2423:
2420:
2416:
2413:
2412:
2411:
2407:
2404:
2403:
2401:
2399:
2395:
2392:
2390:Either / both
2388:
2378:
2375:
2373:
2370:
2368:
2365:
2361:
2358:
2357:
2356:
2355:
2351:
2347:
2344:
2342:
2339:
2338:
2337:
2336:
2332:
2331:
2329:
2327:
2323:
2317:
2314:
2312:
2309:
2307:
2304:
2302:
2299:
2297:
2294:
2292:
2289:
2288:
2286:
2284:
2280:
2274:
2271:
2269:
2266:
2264:
2261:
2259:
2258:Hip dysplasia
2255:
2252:
2251:
2249:
2247:
2243:
2240:
2238:
2234:
2224:
2221:
2219:
2216:
2214:
2211:
2209:
2206:
2205:
2203:
2201:
2197:
2191:
2188:
2186:
2183:
2181:
2178:
2177:
2175:
2173:
2169:
2165:
2162:
2160:
2156:
2153:
2151:
2147:
2143:
2139:
2135:
2131:
2127:
2120:
2115:
2113:
2108:
2106:
2101:
2100:
2097:
2081:
2080:Syringomyelia
2078:
2076:
2073:
2071:
2068:
2067:
2065:
2061:
2055:
2052:
2050:
2047:
2046:
2044:
2042:
2038:
2035:
2033:
2029:
2017:
2014:
2013:
2012:
2009:
2008:
2003:
2000:
1998:
1995:
1994:
1993:
1992:
1988:
1987:
1984:
1981:
1979:
1976:
1974:
1971:
1969:
1966:
1965:
1960:
1957:
1955:
1952:
1950:
1947:
1945:
1944:Lissencephaly
1942:
1940:
1937:
1936:
1935:
1932:
1931:
1926:
1923:
1922:
1921:
1918:
1916:
1913:
1912:
1910:
1906:
1900:
1897:
1895:
1894:Encephalocele
1892:
1888:
1885:
1883:
1880:
1878:
1875:
1872:
1871:
1870:
1867:
1866:
1864:
1862:
1858:
1855:
1853:
1849:
1845:
1841:
1834:
1829:
1827:
1822:
1820:
1815:
1814:
1811:
1805:
1802:
1801:
1791:
1787:
1786:
1782:
1780:
1776:
1775:
1771:
1767:
1765:
1761:
1760:
1756:
1752:
1751:
1748:
1743:
1739:
1717:
1713:
1707:
1699:
1698:
1693:
1686:
1672:
1668:
1664:
1660:
1656:
1652:
1648:
1644:
1640:
1633:
1619:
1615:
1611:
1607:
1603:
1599:
1595:
1588:
1580:
1576:
1572:
1568:
1564:
1560:
1556:
1552:
1545:
1529:
1523:
1515:
1511:
1507:
1503:
1498:
1493:
1489:
1485:
1481:
1474:
1466:
1462:
1458:
1454:
1450:
1446:
1442:
1438:
1431:
1423:
1419:
1415:
1411:
1407:
1403:
1396:
1394:
1378:
1372:
1364:
1360:
1355:
1350:
1346:
1342:
1338:
1331:
1323:
1317:
1309:
1303:
1299:
1292:
1285:
1281:
1275:
1271:
1264:
1256:
1252:
1247:
1242:
1238:
1234:
1230:
1223:
1216:
1213:
1207:
1201:
1197:
1190:
1183:
1178:
1172:
1168:
1161:
1153:
1146:
1139:
1135:
1129:
1125:
1118:
1110:
1106:
1102:
1098:
1094:
1090:
1086:
1082:
1075:
1067:
1063:
1059:
1055:
1051:
1047:
1043:
1039:
1035:
1028:
1013:
1009:
1005:
999:
988:
984:
977:
971:
969:
954:
950:
943:
935:
931:
926:
921:
917:
913:
908:
907:10.14444/4026
903:
899:
895:
891:
884:
876:
872:
867:
862:
857:
852:
849:(5): e24679.
848:
844:
840:
833:
831:
829:
813:
809:
803:
801:
787:
783:
779:
775:
768:
754:
750:
744:
730:
726:
720:
712:
706:
702:
695:
693:
691:
689:
687:
685:
669:
665:
661:
655:
648:
642:
640:
638:
636:
631:
623:
614:
612:
608:
604:
600:
596:
590:
588:
584:
579:
577:
573:
569:
565:
561:
556:
554:
548:
539:
537:
531:
529:
525:
520:
518:
514:
512:
502:
495:
492:
489:
486:
485:
484:
476:
474:
470:
466:
462:
452:
445:
442:
439:
436:
433:
430:
428:
424:
421:
418:
415:
410:
407:
404:
403:
402:
399:
398:
397:
386:
385:Syringomyelia
383:
381:
378:
376:
373:
371:
368:
366:
363:
361:
358:
356:
353:
352:
346:
344:
340:
337:
333:
329:
325:
324:kidney stones
321:
317:
314:, a positive
313:
309:
308:hyperreflexia
305:
297:
294:
290:
286:
283:
280:
277:
276:
275:
272:
270:
266:
265:syringomyelia
261:
254:
250:
246:
243:
240:
238:Low back pain
237:
234:
230:
227:
224:
223:
218:
211:
208:
207:
206:
198:
196:
191:
187:
183:
179:
175:
171:
167:
163:
159:
155:
147:
144:
142:
138:
134:
130:
125:
113:
110:
102:
99:December 2017
91:
88:
84:
81:
77:
74:
70:
67:
63:
60: –
59:
55:
54:Find sources:
48:
44:
38:
37:
32:This article
30:
26:
21:
20:
2618:Macrocephaly
2464:
2460:Acheiropodia
2432:Ectrodactyly
2352:
2333:
2218:Oligodactyly
2213:Clinodactyly
2142:Appendicular
2054:Rachischisis
2049:Spina bifida
1997:Porencephaly
1989:
1933:
1915:Microcephaly
1887:Iniencephaly
1783:
1768:
1753:
1719:. Retrieved
1715:
1706:
1695:
1685:
1674:. Retrieved
1646:
1642:
1632:
1621:. Retrieved
1601:
1598:Neurosurgery
1597:
1587:
1554:
1550:
1544:
1532:. Retrieved
1522:
1487:
1483:
1473:
1440:
1436:
1430:
1408:(1): 21–27.
1405:
1401:
1381:. Retrieved
1371:
1344:
1340:
1330:
1316:
1297:
1291:
1283:
1269:
1263:
1236:
1232:
1222:
1211:
1209:
1195:
1189:
1180:
1166:
1160:
1151:
1145:
1137:
1123:
1117:
1084:
1080:
1074:
1041:
1037:
1027:
1016:. Retrieved
1007:
998:
987:the original
982:
956:. Retrieved
952:
942:
897:
893:
883:
846:
842:
816:. Retrieved
811:
789:, retrieved
777:
767:
756:. Retrieved
752:
743:
732:. Retrieved
728:
719:
700:
672:. Retrieved
663:
654:
620:
591:
580:
557:
549:
545:
532:
521:
515:
508:
499:
490:incontinence
482:
461:spina bifida
458:
455:Spina bifida
449:
401:Spina bifida
394:
370:Spina Bifida
316:stretch sign
312:hyporeflexia
301:
289:incontinence
273:
262:
258:
249:incontinence
204:
195:spina bifida
157:
153:
152:
146:Neurosurgery
105:
96:
86:
79:
72:
65:
53:
41:Please help
36:verification
33:
2648:Saddle nose
2415:Webbed toes
2406:Polydactyly
2291:Genu valgum
2223:Polydactyly
2032:Spinal cord
1869:Anencephaly
1716:Spinabifida
1697:Answers.com
587:laminectomy
411:Meningocele
180:), occult,
166:spinal cord
132:Other names
2623:Platybasia
2559:Oxycephaly
2472:Phocomelia
2466:Ectromelia
2442:Stub thumb
2410:Syndactyly
2377:Hammer toe
2346:Pigeon toe
2296:Genu varum
2268:Coxa valga
2126:Congenital
1954:Pachygyria
1840:Congenital
1785:DiseasesDB
1721:2022-05-02
1676:2022-06-09
1623:2022-06-09
1383:2008-08-28
1347:(1): 1–5.
1018:2022-11-28
958:2017-11-07
818:2017-12-12
791:2022-11-28
778:StatPearls
758:2022-11-28
734:2022-11-28
674:2022-11-28
626:References
576:TENS units
551:vertebral
336:postpartum
304:amyotrophy
271:symptoms.
69:newspapers
2675:Scoliosis
2482:Hemimelia
2367:Pes cavus
2360:Flat feet
2341:Club foot
2273:Coxa vara
1882:Acalvaria
1490:(1): E5.
1239:(2): E8.
1101:0022-3085
1058:0022-3085
916:2211-4599
900:(4): 26.
617:Prognosis
583:scoliosis
553:osteotomy
542:Treatment
505:Diagnosis
496:scoliosis
479:Mechanism
360:Scoliosis
293:retention
253:retention
242:Scoliosis
141:Specialty
2793:Category
2725:Cervical
2172:shoulder
2168:clavicle
2150:dysmelia
1991:CNS cyst
1873:Acephaly
1671:12094020
1663:15292632
1579:12094020
1571:15292632
1506:20594003
1465:40180033
1457:19829247
1422:21495816
1363:16749759
1255:17961012
1012:Archived
934:29372130
875:35663696
786:31082126
668:Archived
451:damage.
355:Kyphosis
320:nocturia
190:tethered
186:dermoids
2740:sternum
1877:Acrania
1618:8413866
1514:6452934
1212:support
1152:Medlink
1109:6259301
1066:6259301
925:5779270
866:9160501
564:opiates
405:Occulta
210:Lesions
83:scholar
2763:other:
2477:Amelia
2354:valgus
1779:742.59
1669:
1661:
1616:
1577:
1569:
1534:2 July
1530:. UCLA
1512:
1504:
1463:
1455:
1420:
1361:
1304:
1276:
1253:
1202:
1173:
1130:
1107:
1099:
1064:
1056:
932:
922:
914:
873:
863:
843:Cureus
784:
707:
560:NSAIDs
432:Lipoma
343:atonic
184:, and
85:
78:
71:
64:
56:
2730:Bifid
2611:other
2528:Axial
2335:varus
2063:Other
1908:Other
1852:Brain
1790:34471
1764:Q06.8
1667:S2CID
1575:S2CID
1510:S2CID
1461:S2CID
1437:Spine
990:(PDF)
979:(PDF)
605:, or
391:Cause
330:, or
90:JSTOR
76:books
2716:ribs
2283:knee
2159:Arms
2146:limb
1774:9-CM
1659:PMID
1614:PMID
1567:PMID
1536:2013
1502:PMID
1453:PMID
1418:PMID
1359:PMID
1302:ISBN
1274:ISBN
1251:PMID
1200:ISBN
1171:ISBN
1128:ISBN
1105:PMID
1097:ISSN
1062:PMID
1054:ISSN
953:AANS
930:PMID
912:ISSN
871:PMID
782:PMID
705:ISBN
487:legs
233:gait
62:news
2246:hip
2237:Leg
1770:ICD
1755:ICD
1651:doi
1606:doi
1559:doi
1492:doi
1445:doi
1410:doi
1349:doi
1241:doi
1089:doi
1046:doi
920:PMC
902:doi
861:PMC
851:doi
517:MRI
326:),
310:or
291:or
251:or
158:TCS
45:by
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