Tethered Cord Syndrome with Syrinx in A Nigerian Adult Female: A Case Report

Backround: Tethered cord syndrome is a diverse clinical entity secondary to any of a heterogeneous group of spinal disorders that typically occurs in children, but occurs as a rare pathologic entity in adults. The occurrence of tethered cord and spinal cord syrinx in an adult Nigerian is quite rare. Methods: The case record of the patient in review and literature search on the subject of tethered cord syndrome and spinal cord syrinx. Results: A 35 years female Nigerian, admitted into the department of internal medicine of the University of Port Harcourt teaching hospital with one month history of progressive weakness of the lower limbs associated with gradual loss of sensation in legs, urinary incontinence but no fecal incontinence or back pain. There was no history of trauma or chronic cough. Examination revealed reduced power in both lower limbs with loss of peripheral sensation, pain and light touch beginning at the level of L3, power in upper limbs was normal and the cranial nerves were intact. Urogenital and Musculoskeletal systems examination were normal. The respiratory and gastrointestinal systems were all normal. There were no cutaneous stigmata (hypertrichosis). Laboratory investigations showed normal hematological indices. Urinalysis was also normal. An impression of acute transverse myelitis was made. Magnetic resonance imaging showed tethered cord and syrinx in the lumbar region. Conclusion: Tethered cord association with syringomyelia in adults is rare, although with the use of modern imaging tools like MRI, the diagnosis of TCS is no more as rare as it is thought and should be sought for in the appropriate clinical setting. Keywords: Tethered cord; Syringomyelia; MRI; Adult; Nigeria.