Microsurgical efficacy in 326 children with tethered cord syndrome: a retrospective analysis

Shang, Aijia; Yang, Chang‐Hao; Cheng, Cheng; Tao, Benzhang; Zhang, Yuanzheng; Gao, Haihao; Bai, Shaocong

doi:10.4103/1673-5374.243720

Cited by 13 publications

(7 citation statements)

References 26 publications

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“…21 A correct clinical categorization for tethered cord syndrome will help predict prognosis and guide treatment. 22 In 22 patients, Duz et al 23 observed a 5% CSF leak and no illnesses. Sofuoglu et al 24 documented CSF leak and wound infection in three individuals (13 percent).…”

Section: Discussionmentioning

confidence: 98%

Frequency of SCF Leakage in Post-operative Patients of Tethered Spinal Cord in A Tertiary Care Hospital

et al. 2022

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Objective: The study aimed to report the incidence of CSF leakage in patients with a tethered spinal cord, post-operatively. Materials and Methods: A total of 75 individuals aged more than 2 years and of either gender who were hospitalized for surgery for tethered cord syndrome were included. All patients had a preoperative MRI of the spine, and those above the age of 6 had urodynamic tests. Clinical evaluations were performed until hospital release, then again at 3, 6, and 12 months. Urodynamic tests and spine MRIs were redone one year following surgery. Under general anesthesia, all patients had microscopic untethering procedures to release tethering materials and heal the thecal sac. Results: 52% of patients fall under TCS type ‘simple’, whereas, 48% of patients found with complex TCS. The frequency of CSF leakage in post-operative patients with a tethered spinal cord was found in 17.33%. No CSF leak was reported in the majority of patients (49%) patients in the age group 2-30 years. 52% of patients with simple TCS reported no CSF leak, whereas, only 13(18%) patients with complex TCS reported CSF leaks. 40% of patients reported no CSF leak who was diagnosed with complex TCS. There existed a significant relationship between the types of TCS (simple/complex) for CSF leak distribution. Conclusion: This study concluded that the frequency of CSF leakage in post-operative patients with tethered spinal cord was found in 17.33% of patients. Keywords: Tethered Spinal Cord (TCS), CSF Leakage, Lipomyelomeningocele.

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Section: Discussionmentioning

confidence: 98%

Frequency of SCF Leakage in Post-operative Patients of Tethered Spinal Cord in A Tertiary Care Hospital

et al. 2022

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“…Scoliosis correction surgery was performed 3 to 6 months later. [12,18] Although this method has achieved some therapeutic effects, a large number of studies have shown that tether release is generally better for children with a tethered spinal cord, but for adult patients, this treatment method has a high incidence of complications, a high proportion of incomplete tether release, and a high rate of re-tethering. [19][20][21] In addition, secondary surgery and secondary anesthesia are required, increasing the patient's pain and the risk of surgery.…”

Section: Discussionmentioning

confidence: 99%

“…[11] TCS mostly occurs in childhood. [12] Although adult patients with primary TCS have spinal cord traction factors, during development, the spinal cord function and traction factors reach a critical balance, and there are often no obvious symptoms in the early stage. [13] However, this balance is very fragile and often broken under inducements such as trauma, and the corresponding clinical symptoms will appear at that time.…”

Section: Discussionmentioning

confidence: 99%

Dekyphosis operation combined with limited osteotomy to treat the symptomatic adult tethered cord syndrome with complicated malformations: A case report

Ji¹,

Xiao²,

Wang³

et al. 2023

Medicine

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Rationale: Tethered cord syndrome (TCS) represents a spectrum of neurological symptoms that are caused by constant or intermittent axial traction of the terminal cone of the spinal cord due to abnormal positioning. It is uncommon for abnormal structures of TCS to be accompanied by split cord malformation, thoracic spinal stenosis, and other spinal cord diseases. Patient concerns: A 45-year-old male patient visited our hospital due to severe lower back pain, extensive left lower limb muscle weakness, and intermittent claudication. Diagnoses: TCS combined with stenosis of the thoracic canal, split cord malformation, and kyphosis deformity. Interventions: The patient underwent Dekyphosis operation combined with limited osteotomy symptoms. Outcomes: The patient felt the right lower limb improved after surgery. At 4-month follow-up, a radiological examination showed adequate decompression of the spinal cord and a good internal fixation position. Overall, the patient’s clinical symptoms significantly improved. Conclusion: This is a rare case of TCS combined with thoracic disc herniation and bony mediastinum. A more conservative invasive surgical approach was elected and markedly improved the patient’s symptoms. Additional clinical cases are needed to confirm the stability and feasibility of this surgical approach.

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“…Hsieh et al found one transient urological dysfunction out of seven operations (14%) that recovered in 4 months [9], while Pang et al reported a rate of 4.76% of postoperative urological dysfunction [15]. Analysing the outcomes of 326 paediatric cases, Shang et al found postoperative urinary retention in six cases (1.8%), lower extremity numbness in nine cases (2.8%) and lower extremity weakness in three cases (1%) [19].…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment of tethered cord syndrome—comparing the results of surgeries with and without electrophysiological monitoring

2019

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Purpose To compare the short-and long-term outcomes after surgical treatment of tethered cord syndrome with and without electrophysiological monitoring. Method We collected the preoperative data of 102 tethered cord surgeries of 91 patients. We compared the outcomes regarding the presence of intraoperative electrophysiology, the types of surgeries and the preoperative neurological condition. We also analysed the long-term outcomes in the cases of 69 patients. Results We found that intraoperative electrophysiology can reduce the perioperative surgical risk significantly (from 9.4 to 2.9%, p < 0.001), and electrophysiology is also beneficial in avoiding long-term progression in 88.7% (p = 0.03341). Conclusion Tethered cord surgeries are safe and effective. With the use of intraoperative electrophysiology, the risk of postoperative worsening is as low as 2.9%, and long-term progression can be avoided in the majority of the patients.

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Microsurgical efficacy in 326 children with tethered cord syndrome: a retrospective analysis

Cited by 13 publications

References 26 publications

Frequency of SCF Leakage in Post-operative Patients of Tethered Spinal Cord in A Tertiary Care Hospital

Frequency of SCF Leakage in Post-operative Patients of Tethered Spinal Cord in A Tertiary Care Hospital

Dekyphosis operation combined with limited osteotomy to treat the symptomatic adult tethered cord syndrome with complicated malformations: A case report

Surgical treatment of tethered cord syndrome—comparing the results of surgeries with and without electrophysiological monitoring

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