CONGENITAL CERVICAL TETHERED SPINAL CORD IN ADULTS: RECOGNITION, SURGICAL TECHNIQUE AND LITERATURE REVIEW. CASE SERIES

Objective: Recognition of congenital tethered cervical cord in adults and literature review.

Methods: Retrospective review of adult onset tethered cervical cord patients (more than 20 years of age).

Results: Three adults were identified; 2 female and 1 male with an average age of 47 years. The presenting symptoms were neck pain with restricted movement (3), quadriparesis (2), sensory changes (2). Hyperreflexia was present in all these. Bony abnormalities were mainly bifid cervical spinous processes (3) and Klippel-Feil abnormalities in 1. The neurocutaneous stigmata was seen in 2. MRI revealed "limited dorsal myeloschisis" in all 3 patients. The dorsal aspect of the cervical cord extruded into the tract leading to the surface.

Conclusions: Neurocutaneous stigmata should not be considered benign. A missed clinical diagnosis was apparent in all 3 patients; 2 of whom underwent surgery with excellent results. MRI can identify the abnormal cervical cord protruding towards the "sinus tract" and allow planning to avert injury to the spinal cord during release.