Low-lying cord is an uncommon entity, and cord compression due
lumbar disc disease is rarely encountered. We discuss our experience with a case of lumbar cord compression secondary to a large
disc protrusion, which caused
myelopathy in a low-lying/tethered cord. A 77-year-old woman with known
spina bifida occulta presented with 6-week history of severe
low back pain and progressive
paraparesis. Magnetic resonance imaging showed a low-lying tethered cord and a large disc
prolapse at L2/3 causing cord compression with associated
syringomyelia. Medical comorbidities precluded her from anterior
decompression, and therefore a posterior
decompression was performed. She recovered full motor power in her lower limbs and could eventually walk unaided. She had a deep
wound infection, which was successfully treated with
debridement, negative pressure
therapy (
vacuum-assisted closure pump), and
antibiotics. Six months after surgery, her Oswestry Disability Index improved from 55% preoperatively to 20%. Posterior spinal cord
decompression for this condition has been successful in our case, and we believe that the lumbar
lordosis may have helped indirectly decompress the spinal cord by posterior
decompression alone.