Spinal cord tethering and syringomyelia after trauma: impact of age and surgical outcome

Bratelj, Denis; Stalder, Susanne; Capone, Crescenzo; Jaszczuk, Phillip; Dragalina, Cristian; Pötzel, Tobias; Gebhard, Cathérine; Fiechter, Michael

doi:10.1038/s41598-023-38565-0

Cited by 4 publications

(1 citation statement)

References 29 publications

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“…Our results revealed that age was significantly associated with the occurrence of spinal cord tethering, with older patients being more likely to develop this complication. This finding is consistent with previous studies suggesting that age-related changes in spinal cord morphology and tissue elasticity may predispose older individuals to an increased risk of tethering following trauma [8][9][10] . Moreover, older age has been linked to decreased regenerative capacity and delayed healing, potentially exacerbating the severity of tethering and complicating surgical intervention.…”

Section: Discussionsupporting

confidence: 93%

Spinal Cord Tethering after Trauma and Impact of Age and Surgical Outcome

Khattak,

Ujjan,

Raza

et al. 2024

PJMHS

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Introduction: Spinal cord tethering, a condition where the spinal cord becomes attached or fixed to surrounding tissues, can occur following trauma, leading to a range of neurological deficits and complications. Objectives: The main objective of the study is to find the spinal cord tethering after trauma and impact of age and surgical outcome in local population of Pakistan. Material and methods: This retrospective study was conducted in Ayub Medical Complex Abbottabad from January 2023 to August 2023. Data was collected from 50 patients of spinal cord tethering patients. Data collection involved a comprehensive review of the medical records of patients. Relevant demographic information, including age at the time of trauma, gender, and comorbidities, was extracted. Clinical details such as mechanism of injury, level and severity of spinal cord injury, duration of symptoms and preoperative neurological status were documented. Results: Data were collected from 50 SCI patients. The mean age of the patients was 45 ± 10.5 years and there were 60% male and 40% female patients. The most common mechanisms of injury were motor vehicle accidents (50%), followed by falls (30%) and sports-related injuries (20%). Regarding the spinal level affected, the majority of injuries were cervical (60%), followed by thoracic (30%) and lumbar (10%). Neurological improvement was observed in 40% of patients, with complete improvement in 40% and partial improvement in 20%, while 40% showed no improvement. Complications were reported in a subset of patients, with cerebrospinal fluid leaks occurring in 15%, wound infections in 10%, and other complications in 5% of cases. Reoperation was necessary in 10% of patients, while 90% did not require further surgical intervention. Age and neurological improvement showed non-significant differences between groups (p > 0.05), while length of hospital stay differed significantly (p = 0.018). Complications and functional improvement did not vary significantly between groups (p > 0.05) Practical Implication: This study's practical implications offer vital benefits to the community. The identification of age as a critical component in spinal cord tethering after trauma enables healthcare practitioners to more accurately evaluate risk and customize therapies. Furthermore, our research emphasizes how successful surgical therapies are for patients of all ages, giving patients confidence in their available treatment alternatives. Further improving patient care is pushing for individualized treatment options and being aware of related consequences. Conclusion: It is concluded that age influences the occurrence of spinal cord tethering following trauma, with older patients being more susceptible to this complication. However, surgical intervention appears to be equally effective across age groups, with comparable rates of neurological improvement and complications. Keywords: Spinal cord tethering, Trauma, Age impact, Surgical outcome, Neurological improvement, Complications

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Section: Discussionsupporting

confidence: 93%

Spinal Cord Tethering after Trauma and Impact of Age and Surgical Outcome

Khattak,

Ujjan,

Raza

et al. 2024

PJMHS

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Neurologic Decline After Spinal Cord Injury

Dymock,

Shahid Salles

2025

Physical Medicine and Rehabilitation Clinics of North America

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Surgical treatment of posttraumatic spinal cord tethering and syringomyelia: a retrospective cohort investigation of cost, reimbursement, and financial sustainability

Jaszczuk,

Bratelj,

Capone

et al. 2024

BMC Surg

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Background Posttraumatic spinal cord tethering and syringomyelia are considered disabling diseases in patients with spinal cord injury. In symptomatic patients, surgical management can achieve promising clinical outcomes. As the raising economic pressure might jeopardize optimal and thus personalized patient care, we aimed to exemplify expenses of surgical treatment in contrast to reimbursement by the Swiss diagnosis related group (DRG) system. Methods This retrospective investigation includes 60 patients who underwent surgery for spinal cord tethering and syringomyelia. The duration of surgeries was used to estimate the costs of care in the operating room (OR) considering established bench marks. Coverage of costs was calculated by comparing Swiss DRG reimbursements with the expenses from the investigated cases. ResultsThe mean duration of surgeries was 251.0 ± 93.5 min while 2.8 ± 1.4 vertebral segments were treated by spinal cord untethering. The mean OR costs (in USD

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Spinal cord tethering and syringomyelia after trauma: impact of age and surgical outcome

Cited by 4 publications

References 29 publications

Spinal Cord Tethering after Trauma and Impact of Age and Surgical Outcome

Spinal Cord Tethering after Trauma and Impact of Age and Surgical Outcome

Neurologic Decline After Spinal Cord Injury

Surgical treatment of posttraumatic spinal cord tethering and syringomyelia: a retrospective cohort investigation of cost, reimbursement, and financial sustainability

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