Importance of Physical Examination and Imaging in the Detection of Tethered Cord Syndrome.
Lisa B E ShieldsIan S MutchnickDennis S PeppasEran RosenbergPublished in: Global pediatric health (2019)
Tethered cord syndrome (TCS) is a type of occult spinal dysraphism that may lead to permanent neurologic and orthopedic deficits. Infants with TCS may have lumbosacral cutaneous malformations (LsCMs). We studied 67 infants referred to a single pediatric urology practice for a urological concern unrelated to occult spinal dysraphism with no prior diagnosis of LsCM between March 1, 2015 and September 30, 2018. Each infant underwent a spinal ultrasound. If an abnormality was detected, they were referred to a pediatric neurosurgeon. The most common cutaneous manifestations were duplicated or bifurcated (46%) gluteal folds and gluteal asymmetry (16%). Fourteen (21%) of the 67 patients had an abnormal spinal ultrasound; 5 of the 14 infants underwent a lumbar magnetic resonance imaging. One infant had urodynamics studies and a tethered cord release. Pediatricians should be familiar with TCS and perform lumbar physical examinations for LsCMs suggestive of TCS to ensure prompt diagnosis and management and avoid potentially devastating complications.
Keyphrases
- magnetic resonance imaging
- spinal cord
- minimally invasive
- physical activity
- end stage renal disease
- mental health
- ejection fraction
- healthcare
- newly diagnosed
- high resolution
- case report
- primary care
- traumatic brain injury
- spinal cord injury
- peritoneal dialysis
- prognostic factors
- quality improvement
- urinary tract
- contrast enhanced ultrasound
- real time pcr
- label free