• World Neurosurg · Jul 2017

    Case Reports

    Neurological Decline in an Elderly with Repaired Myelomeningocele Complicated with Lumbar Canal Stenosis: a case report.

    • Shingo Matsuda, Satoshi Yamaguchi, Yosuke Kajihara, Masaaki Takeda, Manish Kolakshyapati, and Kaoru Kurisu.
    • Department of Neurosurgery, Hiroshima University Graduate School of Biomedical and Health Sciences, Hiroshima, Japan. Electronic address: 1108shingo@gmail.com.
    • World Neurosurg. 2017 Jul 1; 103: 952.e1-952.e4.

    BackgroundTethered cord syndrome is a well-known complication after myelomeningocele (MMC) repair in childhood. However, late complications in adults with a repaired MMC are not well understood. In particular, the influence of a degenerative spinal deformity on a sustained tethered cord is still unclear.Case DescriptionA 63-year-old man with a repaired MMC exhibited a progressive gait disturbance and numbness in both lower limbs. Magnetic resonance imaging demonstrated that the tethered spinal cord was compressed by severe canal stenosis along the entire lumbar spine. After a multi-level lumbar decompression surgery, the patient recovered to baseline neurologic status.ConclusionIn adults with a repaired MMC, lumbar canal stenosis should be investigated as a possible cause of late neurologic decline. Clinical manifestations may be complicated by the coexistence of both the original and subsequent neurologic disorders. Because these additional disorders result from compressive myelopathy, early surgical decompression is indicated to avoid irreversible spinal cord dysfunction.Copyright © 2017 Elsevier Inc. All rights reserved.

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