Tethered cord syndrome in adolescents: Report of two cases and review of literature
A 19-year-old girl presented with perianal sensory loss with bowel and bladder incontinence for about 4 years. Following excision of a lipoma in her right gluteal region 2 years back she developed low back pain radiating down the legs. Her examination findings revealed bilateral small muscle atrophy of feet with weak plantar flexion. She had perianal sensory loss with patulous anal sphincter. Low lying conus and sacral lipomyelomeningocele causing cord tethering was encountered in the MRI of the lumbosacral spine []. Her urodynamic study showed underactive detrusor contractility. On operation, an intradural lipomatous mass attached to the distal end of thick, dilated filum terminale with entangled lower sacral roots was found. Untethering of the cord following excision of the lipomatous mass was carried out. Post-operatively she gained gradual self-control over her bladder in a period of over 6 months.