A Case of Tethered Cord Syndrome induced by Head Injury

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A thirteen-year-old girl with lumbosacral lipoma was originally operated on at three months of age. After partial resection of the lipoma and untethering, her condition followed a good course with minimal bladder dysfunction despite suspicion of retethering as shown on magnetic resonance imaging (MRI). At the age of thirteen years old, she was admitted to our hospital complaining of transient consciousness loss after she slipped down on the ground while playing tennis. Muscle weakness and hypesthesia were present in her left leg and MRI revealed a tethered cord which was consistent with the previous findings. Untethering was performed three months later and the symptoms involving her lower extremity improved after the surgery. Her sphincter function became disturbed transiently, but came into remission within two months. Retethering after spinal lipoma surgery is not rare, which leads to exacerbation of tethered cord syndrome (TCS) and it is well known that head trauma or exercise is relevant to the onset of TCS in adolescents with occult spina bifida. Careful consideration should be given to the management of recurrent TCS although the timing and operative method of untethering are still controversial.