Yamada Shokei, Won Daniel J, Pezeshkpour Gholam, Yamada Brian S, Yamada Shoko M, Siddiqi Javed, Zouros Alexander, Colohan Austin R T
Department of Neurosurgery, Loma Linda University School of Medicine, Loma Linda, California 92354, USA. yamada1000.gmail.com
Neurosurg Focus. 2007;23(2):E6. doi: 10.3171/FOC-07/08/E6.
Tethered cord syndrome (TCS) is a stretch-induced functional disorder of the spinal cord due to the fact that its caudal portion is anchored by an inelastic structure. The functional lesion of TCS is generally situated in the lumbosacral cord, and many authors have shown that the syndrome is reversible via surgery to untether the cord. To clarify the expressions relevant to TCS, such as "cord tethering" and "tethered cord," the authors have formulated three categories. These categories include cases that show the anatomical appearance of spinal cord stretching. Among them, Category 1 is isolated to represent the "true TCS." The authors focus their discussion of the pathophysiology of TCS on Category 1 to explain the impaired oxidative metabolism and electrophysiological derangements within the tethered spinal cord, which is the primary intrinsic cause of the dysfunction. Furthermore, they extend the discussion to the extrinsic (outside the spinal cord) factors and other complex conditions that mimic TCS.
脊髓拴系综合征(TCS)是一种由于脊髓尾端被无弹性结构固定而导致的脊髓拉伸性功能性障碍。TCS的功能性损伤通常位于腰骶段脊髓,许多作者已经表明,通过手术松解脊髓,该综合征是可逆的。为了阐明与TCS相关的表述,如“脊髓拴系”和“拴系脊髓”,作者制定了三类。这些类别包括显示脊髓拉伸解剖外观的病例。其中,第1类单独代表“真性TCS”。作者将对TCS病理生理学的讨论集中在第1类,以解释拴系脊髓内氧化代谢受损和电生理紊乱,这是功能障碍的主要内在原因。此外,他们将讨论扩展到外在(脊髓外)因素和其他模拟TCS的复杂情况。