Managing chronic pain in children and adolescents: Tethered cord syndrome should be considered

doi:10.1136/bmj.327.7416.681-a

BMJ 2003;327:681 (20 September), doi:10.1136/bmj.327.7416.681-a

Letter

Managing chronic pain in children and adolescents

Tethered cord syndrome should be considered

The first 150 words of the full text of this article appear below.

EDITOR—Eccleston and Malleson refer to the important andoften frustrating topic of managing chronic pain in childrenand adolescents.¹ I reported a case of a 15 year old schoolgirlwith chronic increasing pain (for approximately three years)of the thoracolumbar junction that extended bilaterally intothe buttocks and posteriorly to the hip joints, with some intermittentbilateral pain around the lower rib cage laterally and anteriorlywith some numbness in the legs and feet.² She had been diagnosedas having growing pains and was having difficulty coping withschool work.

The possibility of functional tethered cord syndrome shouldbe considered when adolescent patients present with unexplainedlumbar, buttock, and leg symptoms. The diagnosis of functionaltethered cord syndrome in this 15 year old patient's case wasconfirmed at surgery, when an L5 laminectomy was performed tosection the filum to release the tethered spinal cord, the tetheredfilum . . . [Full text of this article]

Lynton G Giles, adjunct associate professor

School of Public Health and Tropical Medicine, James Cook University, Townsville, Queensland 4810, Australia lgiles@austarnet.com.au