The lumbosacral angle does not reflect progressive tethered cord syndrome in children with spinal dysraphism

Cornips, Erwin M. J.; Razenberg, Femke G. E. M.; Rhijn, Lodewijk W. van; Soudant, Dan; Raak, E.P.M. van; Weber, Jacobiene W.; Robben, Simon G. F.; Fock, Johanna M.; Catsman‐Berrevoets, Coriene E.; Vles, J. S. H.

doi:10.1007/s00381-010-1281-0

Cited by 6 publications

(4 citation statements)

References 10 publications

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“…Asymptomatic SBO is common in normal children; it is no more likely when LUT dysfunction of unknown origin is present . Controversy exists whether or not an increasing lumbosacral angle might suggest progressive TSC . In utero MRI is sensitive in diagnosing the obvious OSD .…”

Section: Presenting Clinical Findings and Evaluation Methodsmentioning

confidence: 99%

“…38 Controversy exists whether or not an increasing lumbosacral angle might suggest progressive TSC. 39,40 In utero MRI is sensitive in diagnosing the obvious OSD. 41 Various other supplementary MRI techniques (cine, flexion, extension, supine, and prone) are ineffective diagnostic tools that do not reliably identify good candidates for surgery.…”

Section: Other Evaluation Methods For Suspected Osd and Tcsmentioning

confidence: 99%

See 1 more Smart Citation

Evaluation and management of tethered cord syndrome in occult spinal dysraphism: Recommendations from the international children's continence society

Tuite

Thompson

Austin

et al. 2017

Neurourology and Urodynamics

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Infants with classic cutaneous markers of OSD, with progressive neurologic, skeletal, and/or urologic findings, present no diagnostic or therapeutic dilemma: they routinely undergo MRI and SCU. Conversely, in asymptomatic patients or those with fixed, minor abnormalities, the risk profile of these OSD cohorts should be carefully considered before SCU is performed. Irrespective of whether or not SCU is performed, patients at risk for progression should be followed carefully throughout childhood and adolescence by a multidisciplinary team.

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Section: Presenting Clinical Findings and Evaluation Methodsmentioning

confidence: 99%

Section: Other Evaluation Methods For Suspected Osd and Tcsmentioning

confidence: 99%

Evaluation and management of tethered cord syndrome in occult spinal dysraphism: Recommendations from the international children's continence society

Tuite

Thompson

Austin

et al. 2017

Neurourology and Urodynamics

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show abstract

“…Recent studies have failed to confirm an association between lumbosacral angle and progressive tethered cord but this may be limited due to small sample sizes in several studies. [ 5 ]…”

Section: Discussionmentioning

confidence: 99%

The International Tethered Cord Partnership: Beginnings, process, and status

Mulholland

Aranda²,

Arredondo³

et al. 2011

Surg Neurol Int

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Background:Spina bifida presents a significant cause of childhood morbidity in lower- and middle-income nations. Unfortunately, there is a paucity of literature examining outcomes among children with spina bifida in these countries. The goal of the International Tethered Cord Parternship is twofold: (1) to establish an international surveillance database to examine the correlation between time of repair and clinical outcomes in children with spina bifida and tethered cord; and (2) to foster collaboration among international institutions around pediatric neurosurgical concerns.Methods:Twelve institutions in 7 countries committed to participating in the International Tethered Cord Partnership. A neurosurgeon at each institution will evaluate all children presenting with spina bifida and/or tethered cord using the survey instrument after appropriate consent is obtained. The instrument was developed collaboratively and based on previous measures of motor and sensory function, ambulation, and continence. All institutions who have begun collecting data received appropriate Institutional Review Board approval. All data will be entered into a Health Insurance Portability and Accountability Act (HIPAA) compliant database. In addition, a participant restricted internet forum was created to foster communication and includes non–project-specific communications, such as case and journal article discussion.Results:From October 2010 to December 2010, 82 patients were entered from the various study sites.Conclusion:To our knowledge this is the first international pediatric neurosurgical database focused on clinical outcomes and predictors of disease progression. The collaborative nature of the project will not only increase knowledge of spina bifida and tethered cord, but also foster discussion and further collaboration between neurosurgeons internationally.

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“…Pain is more frequent in aged children. Regarding the lumbosacral angle, although some supported its relationship to pain and retethering, its clinical value seems unclear 11) .…”

Section: Type Of Manifestationmentioning

confidence: 99%

Retethering : A Neurosurgical Viewpoint

Lee

Kim

Park

et al. 2020

J Korean Neurosurg Soc

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During the follow-up period after surgery for spinal dysraphism, a certain portion of patients show neurological deterioration and its secondary phenomena, such as motor, sensory or sphincter changes, foot and spinal deformities, pain, and spasticity. These clinical manifestations are caused by tethering effects on the neural structures at the site of previous operation. The widespread recognition of retethering drew the attention of medical professionals of various specialties because of its incidence, which is not low when surveillance is adequate, and its progressive nature. This article reviews the literature on the incidence and timing of deterioration, predisposing factors for retethering, clinical manifestations, diagnosis, surgical treatment and its complications, clinical outcomes, prognostic factors after retethering surgery and preventive measures of retethering. Current practice and opinions of Seoul National University Children's Hospital team were added in some parts. The literature shows a wide range of data regarding the incidence, rate and degree of surgical complications and long-term outcomes. The method of prevention is still one of the main topics of this entity. Although alternatives such as spinal column shortening were introduced, re-untethering by conventional surgical methods remains the current main management tool. Re-untethering surgery is a much more difficult task than primary untethering surgery. Updated publications include strong skepticism on re-untethering surgery in a certain group of patients, though it is from a minority of research groups. For all of the abovementioned reasons, new information and ideas on the early diagnosis, treatment and prevention of retethering are critically necessary in this era.

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The lumbosacral angle does not reflect progressive tethered cord syndrome in children with spinal dysraphism

Cited by 6 publications

References 10 publications

Evaluation and management of tethered cord syndrome in occult spinal dysraphism: Recommendations from the international children's continence society

Evaluation and management of tethered cord syndrome in occult spinal dysraphism: Recommendations from the international children's continence society

The International Tethered Cord Partnership: Beginnings, process, and status

Retethering : A Neurosurgical Viewpoint

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