![](https://d3ilqtpdwi981i.cloudfront.net/r1NVRgXBZwpyfPDudkM_r7Se2zA=/425x550/smart/https://bepress-attached-resources.s3.amazonaws.com/uploads/4f/25/88/4f25886d-e95f-4994-869f-7112cf842fa2/thumbnail_f39f1d91-d228-41c6-84ed-175e1e3c669b.jpg)
Background:
Synchronous spinal intradural ependymal cysts and sacral Tarlov cysts in adult onset tethered cord syndrome are extremely rare. Case Description:
A 23-year-old male presented with back pain radiating into both lower extremities, accompanied by acute onset of gait difficulty and sphincter dysfunction. Magnetic resonance imaging identified a low lying conus medullaris, syringomyelia with septations extending from T12 to S1, a tethered cord, and a thickened filum terminale with a sacral Tarlov cyst. The patient underwent a L3-4 laminectomy for decompression of syringomyelia and excision/biopsy of a space occupying lesion along with S1-2 laminectomy for cord untethering and Tarlov cyst fenestration. Postoperative histopathology confirmed that the lesion was an ependymal cyst. Clinically, patient showed marked improvement in the neurological status. Conclusion:
Simultaneous decompressive laminectomy of L3-4 and S1-2 effectively decompressed the syringomyelia while allowing for excision/biopsy of a space occupying lesion at the former and untethering and Tarlov cyst fenestration at the latter levels.
Available at: http://works.bepress.com/ather_enam/12/