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KMID : 1146020100030010022
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Journal of Critical Spine Cases
2010 Volume.3 No. 1 p.22 ~ p.24
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The Tethered Spinal Cord Syndrome Misdiagnosed as a Degenerative Disc Disease in Patient with Low Back Pain
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Hur Sung-Min
Choi Kyung-Chul
Ahn Yong
Lee Sang-Ho
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Abstract
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We reported a rare case of tethered cord syndrome which is misdiagnosed as a degenerative disc disease (DDD) in patient with low back pain (LBP). A 55-years-old female patient visited our institute with LBP. On lumbar flexion position, severe back pain occurred which is recently aggravated. On magnetic resonance imaging (MRI) of other clinic, there were multi-level severe disc degenerations. The patient presented with concordant pain of L5-S1 on provocative discography. The MRI was very low quality. So, on rechecked MRI at our institute, there was low-lying conus medullaris at L3 body and thickened filum terminale in the thecal sac. We released of tethered cord after total laminectomy of L5 and durotomy. Postoperatively, the back pain improved according to visual analogue scale scores from 10 to 3. On postoperative MRI, there was detethered cord moving upward. In this case, the low quality of MRI can make the misdiagnosis of DDD in tethered spinal cord disease. The careful imaging study and patient's symptom evaluation could prevent misdiagnosis of many causes of LBP disease.
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KEYWORD
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Low back pain, Tethered cord syndrome, Degenerative disc disease
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