{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,30]],"date-time":"2025-10-30T11:36:26Z","timestamp":1761824186794},"reference-count":35,"publisher":"Scientific Scholar","content-domain":{"domain":["surgicalneurologyint.com"],"crossmark-restriction":true},"short-container-title":[],"abstract":"\nBackground: <\/jats:title>\nIn a split cord malformation (SCM), the spinal cord is divided longitudinally into two distinct hemicords that later rejoin. This can result in a tethered cord syndrome (TCS). Rarely, TCS secondary to SCM presents in adulthood. Here, we present an adult female with Type I SCM resulting in TCS and a review of literature.<\/jats:p>\n<\/jats:sec>\n\nCase Description: <\/jats:title>\nA 57-year-old female with a history of spina bifida occulta presented with a 2-year history of worsening back and left leg pain, difficulty with ambulation, and intermittent urinary incontinence; she had not responded to conservative therapy. Magnetic resonance imaging (MRI) revealed a tethered cord secondary to lumbar type I SCM. The patient underwent an L1\u2013S1 laminectomy for resection of the bony septum with cord detethering. At 2-month follow-up, the patient had improvement in her motor symptoms and less pain. In literature, 25 cases of adult-onset surgically managed SCM with TCS were identified (between 1936 and 2018). Patients averaged 37 years of age at the time of diagnosis, and 56% were female.<\/jats:p>\n<\/jats:sec>\n\nConclusion: <\/jats:title>\nTCS can present secondary to SCM in adulthood and is characterized predominantly by back and leg pain.<\/jats:p>\n<\/jats:sec>","DOI":"10.25259\/sni-66-2019","type":"journal-article","created":{"date-parts":[[2019,8,25]],"date-time":"2019-08-25T11:59:50Z","timestamp":1566734390000},"page":"90","update-policy":"http:\/\/dx.doi.org\/10.25259\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Type I split cord malformation and tethered cord syndrome in an adult patient: A case report and literature review"],"prefix":"10.25259","volume":"10","author":[{"given":"Erin N.","family":"D\u2019Agostino","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Geisel School of Medicine, Dartmouth College, Hanover, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel R.","family":"Calnan","sequence":"additional","affiliation":[{"name":"Dartmouth-Hitchcock Medical Center, Section of Neurosurgery, 1 Medical Center Drive, Lebanon, New Hampshire, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vyacheslav I.","family":"Makler","sequence":"additional","affiliation":[{"name":"Section of Neurology, 1 Medical Center Drive, Lebanon, New Hampshire, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Imad","family":"Khan","sequence":"additional","affiliation":[{"name":"Dartmouth-Hitchcock Medical Center, Section of Neurosurgery, 1 Medical Center Drive, Lebanon, New Hampshire, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John H.","family":"Kanter","sequence":"additional","affiliation":[{"name":"Dartmouth-Hitchcock Medical Center, Section of Neurosurgery, 1 Medical Center Drive, Lebanon, New Hampshire, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David F.","family":"Bauer","sequence":"additional","affiliation":[{"name":"Dartmouth-Hitchcock Medical Center, Section of Neurosurgery, 1 Medical Center Drive, Lebanon, New Hampshire, United States."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","published-online":{"date-parts":[[2019,6,7]]},"reference":[{"key":"10.25259\/SNI-66-2019\/ref-1","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s10143-003-0313-6","article-title":"Split cord malformation in adults","volume":"27","author":"Akay","year":"2004","journal-title":"Neurosurg Rev"},{"key":"10.25259\/SNI-66-2019\/ref-2","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s10143-008-0140-x","article-title":"Surgery in adult onset tethered cord syndrome (ATCS): Review of literature on occasion of an exceptional case","volume":"31","author":"Aufschnaiter","year":"2008","journal-title":"Neurosurg Rev"},{"key":"10.25259\/SNI-66-2019\/ref-3","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1007\/s00381-014-2586-1","article-title":"Cutting filum terminale is very important in split cord malformation cases to achieve total release","volume":"31","author":"Barutcuoglu","year":"2015","journal-title":"Childs Nerv Syst"},{"key":"10.25259\/SNI-66-2019\/ref-4","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1227\/00006123-198505000-00019","article-title":"Adult onset of tethered spinal cord syndrome due to fibrous diastematomyelia: Case report","volume":"16","author":"Chehrazi","year":"1985","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI-66-2019\/ref-5","doi-asserted-by":"crossref","first-page":"276","DOI":"10.3171\/jns.1947.4.3.0276","article-title":"Congenital dermal (pilonidal) sinus with dural connection; case report and discussion","volume":"4","author":"Cliffton","year":"1947","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI-66-2019\/ref-6","doi-asserted-by":"crossref","first-page":"272","DOI":"10.1080\/10790268.2008.11760722","article-title":"Tethered cord syndrome in adulthood","volume":"31","author":"D\u00fcz","year":"2008","journal-title":"J Spinal Cord Med"},{"key":"10.25259\/SNI-66-2019\/ref-7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.3171\/foc.2001.10.1.10","article-title":"Diastematomyelia and spinal teratoma in an adult: Case report","volume":"10","author":"Elmac\u0131","year":"2001","journal-title":"Neurosurg Focus"},{"key":"10.25259\/SNI-66-2019\/ref-8","doi-asserted-by":"crossref","first-page":"57","DOI":"10.3171\/jns.1998.88.1.0057","article-title":"Split spinal cord malformations in children","volume":"88","author":"Er\u015fahin","year":"1998","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI-66-2019\/ref-9","doi-asserted-by":"crossref","first-page":"538","DOI":"10.3171\/jns.1961.18.4.0538","article-title":"Late symptoms from diastematomyelia","volume":"18","author":"Freeman","year":"1961","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI-66-2019\/ref-10","first-page":"31","article-title":"Diastematomyelia in the adult","volume":"11","author":"Fulcher","year":"1970","journal-title":"Neurol Neurocir Psiquiatr"},{"key":"10.25259\/SNI-66-2019\/ref-11","first-page":"93","article-title":"Diastematomyelia in an adult","volume":"14","author":"Garcia","year":"1980","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI-66-2019\/ref-12","doi-asserted-by":"crossref","first-page":"246","DOI":"10.1007\/s12098-016-2244-6","article-title":"Long segment bony spur in split cord malformation Type 1","volume":"84","author":"Garg","year":"2017","journal-title":"Indian J Pediatr"},{"key":"10.25259\/SNI-66-2019\/ref-13","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1016\/S0035-3787(04)71163-7","article-title":"Split-cord malformation (diastematolmyelia) presenting in two adults: Case report and a review of the literature","volume":"160","author":"Guilloton","year":"2004","journal-title":"Rev Neurol (Paris)"},{"key":"10.25259\/SNI-66-2019\/ref-14","first-page":"831","article-title":"Pilonidal cyst, spina bifida occulta and bifid spinal cord. Report of a case with review of the literature","volume":"21","author":"Hamby","year":"1936","journal-title":"Arch Pathol"},{"key":"10.25259\/SNI-66-2019\/ref-15","doi-asserted-by":"crossref","first-page":"E344","DOI":"10.1097\/BRS.0b013e318283f6bc","article-title":"Diastematomyelia: A 35-year experience","volume":"38","author":"Huang","year":"2013","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.25259\/SNI-66-2019\/ref-16","first-page":"173","article-title":"Surgical management of tethered spinal cord in adults: Report of 54 cases","volume":"95","author":"H\u00fcttmann","year":"2001","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI-66-2019\/ref-17","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1080\/026886900408360","article-title":"Split cord malformations in myelomeningocele patients","volume":"14","author":"Iskandar","year":"2000","journal-title":"Br J Neurosurg"},{"key":"10.25259\/SNI-66-2019\/ref-18","doi-asserted-by":"crossref","first-page":"2269","DOI":"10.1097\/00007632-200009010-00021","article-title":"Split cord malformation with diastematomyelia presenting as neurogenic claudication in an adult: A case report","volume":"25","author":"Kaminker","year":"2000","journal-title":"Spine (Phila Pa 1976)"},{"key":"10.25259\/SNI-66-2019\/ref-19","doi-asserted-by":"crossref","first-page":"355","DOI":"10.3171\/jns.1979.51.3.0355","article-title":"New data on diastematomyelia","volume":"51","author":"Kennedy","year":"1979","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI-66-2019\/ref-20","doi-asserted-by":"crossref","first-page":"363","DOI":"10.3340\/jkns.2013.54.4.363","article-title":"Split cord malformation combined with tethered cord syndrome in an adult","volume":"54","author":"Kim","year":"2013","journal-title":"J Korean Neurosurg Soc"},{"key":"10.25259\/SNI-66-2019\/ref-21","doi-asserted-by":"crossref","first-page":"258","DOI":"10.3171\/2011.4.SPINE10504","article-title":"Tethered cord syndrome in adults","volume":"15","author":"Klekamp","year":"2011","journal-title":"J Neurosurg Spine"},{"key":"10.25259\/SNI-66-2019\/ref-22","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.spinee.2003.08.028","article-title":"Diastematomyelia presenting as progressive weakness in an adult after spinal fusion for adolescent idiopathic scoliosis","volume":"4","author":"Lewandrowski","year":"2004","journal-title":"Spine J"},{"key":"10.25259\/SNI-66-2019\/ref-23","doi-asserted-by":"crossref","first-page":"852","DOI":"10.1097\/00007632-199404000-00024","article-title":"Adult diastematomyelia","volume":"19","author":"Linn","year":"1994","journal-title":"Spine"},{"key":"10.25259\/SNI-66-2019\/ref-24","doi-asserted-by":"crossref","first-page":"238","DOI":"10.1159\/000320386","article-title":"Teratoma in split cord malformation: An unusual association: A report of two cases with a review of the literature","volume":"46","author":"Maiti","year":"2010","journal-title":"Pediatr Neurosurg"},{"key":"10.25259\/SNI-66-2019\/ref-25","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1016\/0090-3019(82)90350-0","article-title":"Adult diastematomyelia: A complex dysrhaphic state","volume":"18","author":"Maroun","year":"1982","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI-66-2019\/ref-26","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1159\/000078913","article-title":"Split cord malformation as a cause of tethered cord syndrome in a 78-year-old female","volume":"40","author":"Pallatroni","year":"2004","journal-title":"Pediatr Neurosurg"},{"key":"10.25259\/SNI-66-2019\/ref-27","doi-asserted-by":"crossref","first-page":"32","DOI":"10.3171\/jns.1982.57.1.0032","article-title":"Tethered cord syndrome in adults","volume":"57","author":"Pang","year":"1982","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI-66-2019\/ref-28","doi-asserted-by":"crossref","first-page":"201","DOI":"10.1016\/S0090-3019(03)00431-2","article-title":"Split spinal cord malformation in an elderly patient: Case report","volume":"61","author":"Quinones-Hinojosa","year":"2004","journal-title":"Surg Neurol"},{"key":"10.25259\/SNI-66-2019\/ref-29","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1159\/000120536","article-title":"Diastematomyelia in adults. A review","volume":"16","author":"Russell","year":"1990","journal-title":"Pediatr Neurosurg"},{"key":"10.25259\/SNI-66-2019\/ref-30","first-page":"231","article-title":"Thoracic diastematomyelia with concurrent intradural epidermoid spinal cord tumor and cervical syrinx in an adult. Case report","volume":"97","author":"Sheehan","year":"2002","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI-66-2019\/ref-31","first-page":"205","article-title":"Surgery in adults with tethered cord syndrome: Outcome study with independent clinical review","volume":"94","author":"van Leeuwen","year":"2001","journal-title":"J Neurosurg"},{"key":"10.25259\/SNI-66-2019\/ref-32","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.jocn.2018.03.029","article-title":"Surgical management of adult Type 1 split cord malformation. Report of two cases with literature review","volume":"52","author":"Viswanathan","year":"2018","journal-title":"J Clin Neurosci"},{"key":"10.25259\/SNI-66-2019\/ref-33","first-page":"374","article-title":"Tethered cord syndrome and the conus in a normal position","volume":"33","author":"Warder","year":"1993","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI-66-2019\/ref-34","doi-asserted-by":"crossref","first-page":"94","DOI":"10.1227\/00006123-198707000-00022","article-title":"Diastematomyelia of the cervical spinal cord with tethering in an adult","volume":"21","author":"Wolf","year":"1987","journal-title":"Neurosurgery"},{"key":"10.25259\/SNI-66-2019\/ref-35","doi-asserted-by":"crossref","first-page":"E6","DOI":"10.3171\/FOC-07\/08\/E6","article-title":"Pathophysiology of tethered cord syndrome and similar complex disorders","volume":"23","author":"Yamada","year":"2007","journal-title":"Neurosurg Focus"}],"container-title":["Surgical Neurology International"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/surgicalneurologyint.com\/type-i-split-cord-malformation-and-tethered-cord-syndrome-in-an-adult-patient-a-case-report-and-literature-review\/","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/type-i-split-cord-malformation-and-tethered-cord-syndrome-in-an-adult-patient-a-case-report-and-literature-review\/","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,8,25]],"date-time":"2019-08-25T12:00:15Z","timestamp":1566734415000},"score":1,"resource":{"primary":{"URL":"http:\/\/surgicalneurologyint.com\/surgicalint-articles\/type-i-split-cord-malformation-and-tethered-cord-syndrome-in-an-adult-patient-a-case-report-and-literature-review\/"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,6,7]]},"references-count":35,"alternative-id":["10.25259\/SNI-66-2019"],"URL":"https:\/\/doi.org\/10.25259\/sni-66-2019","relation":{},"ISSN":["2152-7806"],"issn-type":[{"value":"2152-7806","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,6,7]]},"article-number":"90"}}