Tethered Spinal Cord Following Meningomyelocele Repair

Of 16 consecutive patients with tethered spinal cord studied, most had undergone repair of a meningomyelocele. All were evaluated using somatosensory evoked potentials at 6 to 12-month intervals. Other possibilities include tethered filum terminale, lipomeningocele, membrana reuniens, and miscellaneous conditions (diastematomyelia, neurenteric cysts, etc.). Metrizamide myelography with polytomography was superior to gas myelography in showing a low-lying cord, obtuse nerve root angles, and a thin subarachnoid space between the cord and the dorsal meninges cephalad to the tether. Surgery is generally helpful in these patients.