Clinical observations on the release of tethered spinal cord in children with intra-operative neurophysiological monitoring: A retrospective study

Jiang, Jipeng; Zhang, Shanshan; Dai, Chen; Jiang, Xianfeng; Niu, Xuegang; Chen, Xuyi; Tang, Fengwu

doi:10.1016/j.jocn.2019.07.080

Cited by 5 publications

(4 citation statements)

References 29 publications

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“…Fewer postoperative complications and complete recovery were seen in the monitoring group when compared to no monitoring group. This provides evidence in support of using IONM to reduce the risk of postoperative neurological deficits and enhance outcome in paediatric patients with tethered cord pathology 37 …”

Section: Methodsmentioning

confidence: 67%

“…This provides evidence in support of using IONM to reduce the risk of postoperative neurological deficits and enhance outcome in paediatric patients with tethered cord pathology. 37 Intraoperative bulbo-cavernous reflex (BCR) during de-tethering of cord surgery in paediatric patients can predict bladder function 6 months after surgery with high specificity (88.5%), especially in patients with a diagnosis other than lipomyelomeningocele (93.4%). This indicates that when BCR is preserved the bladder function is expected to be preserved.…”

Section: Available Evidencementioning

confidence: 99%

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Intraoperative neurophysiological monitoring in paediatric neurosurgery

2021

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Intraoperative neurophysiological monitoring (IONM) in paediatric neurosurgeries is emerging over the past few years, and it is being widely used to decrease the risk of postoperative deficits. The same techniques of IONM used in adults can be used in paediatric patients with some modifications keeping in consideration their immature developing nervous system. Neurophysiology in children differs from that in adults. In paediatric patients, the IONM signals and responses differ according to the age of the child. The type of surgery and the neuronal pathways expected to be at risk, determine the type of IONM modality used. 1,2 Various factors like age, type and location of the lesion, preoperative neurological functional status should be considered while using IONM in paediatric patients. There are also immense challenges with anaesthesia maintenance in children undergoing IONM. Also, the IONM signals and responses are not as easily obtained as in adults due to many factors related to the immature nervous system. 3,4

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Section: Methodsmentioning

confidence: 67%

Section: Available Evidencementioning

confidence: 99%

Intraoperative neurophysiological monitoring in paediatric neurosurgery

2021

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“…53 Furthermore, in a 2019 retrospective study, comparing the outcomes of TCS surgery performed with and without ION in 100 children diagnosed with TCS, more children in the monitored group achieved total release with fewer neurologic complication and better recovery than in the unmonitored group. 54 These studies suggest the utility of ION in minimizing complications of TCS surgery; however, it is difficult to quantify how much. Furthermore, the choice of which modalities of ION to use is not very clear.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, in a 2019 retrospective study, comparing the outcomes of TCS surgery performed with and without ION in 100 children diagnosed with TCS, more children in the monitored group achieved total release with fewer neurologic complication and better recovery than in the unmonitored group. 54…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Neuromonitoring in Tethered Cord Surgery in Children

Abu-Ata,

Pasquali,

Sala

2024

Journal of Clinical Neurophysiology

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Application of neurophysiological monitoring during tethered cord release in children

Guo,

Zheng,

Leng

et al. 2024

Childs Nerv Syst

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Objective The objective of this study was to explore the effect of intraoperative neurophysiological monitoring (IONM) on tethered spinal cord release in children. Methods The clinical data of 454 children with tethered cord syndrome who underwent surgery for tethered cord release were retrospectively analyzed. The children were divided into two groups: the non-IONM group and the IONM group. SPSS 26.0 software was used for statistical analysis. The evaluation indices included the effective rate and incidence of new neurological dysfunction. Results The short-term results showed that the effective rate of the non-IONM group was 14.8%, while that of the IONM group was 15.2%. Additionally, the incidence of new neurological dysfunction was 7.8% in the non-IONM group and 5.6% in the IONM group. However, there was no significant difference between the two groups (P > 0.05). The medium- to long-term follow-up had significant difference (P < 0.05), the response rate was 32.1% in the IONM group and 23.7% in the non-IONM group, and deterioration rates regarding neurological dysfunction were 3.3% in the IONM group and 8.5% in the non-IONM group. Conclusion This study revealed that the use of IONM does not significantly improve the short-term treatment effect of patients undergoing surgery for tethered cord release or reduce the short-term incidence of postoperative new neurological dysfunction. However, the medium- to long-term prognoses of patients in the IONM group were better than those of patients in the non-IONM group.

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Clinical observations on the release of tethered spinal cord in children with intra-operative neurophysiological monitoring: A retrospective study

Cited by 5 publications

References 29 publications

Intraoperative neurophysiological monitoring in paediatric neurosurgery

Intraoperative neurophysiological monitoring in paediatric neurosurgery

Intraoperative Neuromonitoring in Tethered Cord Surgery in Children

Application of neurophysiological monitoring during tethered cord release in children

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