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Case Reports in Neurological Medicine
Volume 2012, Article ID 635029, 4 pages
http://dx.doi.org/10.1155/2012/635029
Case Report

Tethered Cord Syndrome Secondary to the Unusual Constellation of a Split Cord Malformation, Lumbar Myelomeningocele, and Coexisting Neurenteric Cyst

1Neurosurgeon, AIC Kijabe Hospital, P.O. Box 20, Kijabe 00220, Kenya
2Neurosurgery Clinic, University of Wisconsin Hospitals and Clinics, Madison, WI 53792, USA
3School of Health Sciences, Kenyatta University, Nairobi 00100, Kenya

Received 10 June 2012; Accepted 16 July 2012

Academic Editors: P. Berlit, A. E. Cavanna, J. Lazareff, D. Long, and M. Turgut

Copyright © 2012 Humphrey Okechi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

We describe a seminal case report of a child with a tethered cord syndrome secondary to the unusual constellation of a split cord malformation, lumbar myelomeningocele, and coexisting neurenteric cyst. A 17-year-old adolescent girl with a several-month history of myelopathy and urinary incontinence was examined whose spinal MRI scan demonstrated a type II split cord malformation with a large bone spur and an intradural neurenteric cyst in addition to lumbar myelomeningocele. Untethering of the spinal cord was achieved via a lumbar laminectomy. Pathological examination confirmed the intradural cyst to be a neurenteric cyst. Postoperatively there was stabilization of the neurological symptoms. Prophylactic surgery with total resection of the neurenteric cyst when feasible and spinal cord un-tethering appears to be associated with excellent outcomes.