Document Detail


The outcome of tethered cord release in secondary and multiple repeat tethered cord syndrome.
MedLine Citation:
PMID:  19569907     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECT: After primary repair of a myelomeningocele or a lipomyelomeningocele, patients can present with symptoms of secondary tethered cord syndrome (TCS). After surgical untethering, a small percentage of these patients can present with multiple repeat TCS. In patients presenting with secondary or multiple repeat TCS, the role as well the expected outcomes of surgical untethering are not well defined. METHODS: Eighty-four patients who underwent spinal cord untethering after at least 1 primary repair were retrospectively evaluated using scaled and subjective outcome measures at short-term and long-term follow-up visits. Outcomes were analyzed for predictive measures using multivariate logistic regression. RESULTS: Surgical untethering was performed in 66 patients with myelomeningoceles and 18 patients with lipomyelomeningoceles. Fourteen patients underwent multiple repeat spinal cord untethering. Patients were followed up for an average of 6.2 years. Most patients had stability of function postoperatively. Motor function and weakness improved in 7 and 16% of patients at 6 months, respectively, and 6 and 19% of patients at long-term follow-up evaluation, respectively. Of the patients who presented with back pain, 75% had improvement in symptoms at 6 months postoperatively. Younger age at untethering was significantly associated with worse long-term neurological outcomes. The number of previous untethering procedures, original diagnosis, sex, anatomical level, and degree of untethering had no effect on surgical outcomes. CONCLUSIONS: Patients presenting with secondary or multiple repeat TCS may benefit from surgical untethering.
Authors:
Wajd N Al-Holou; Karin M Muraszko; Hugh J Garton; Steven R Buchman; Cormac O Maher
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of neurosurgery. Pediatrics     Volume:  4     ISSN:  1933-0707     ISO Abbreviation:  -     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-02     Completed Date:  2009-08-21     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101463759     Medline TA:  J Neurosurg Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  28-36     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, University of Michigan, Ann Arbor, Michigan, USA.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age Factors
Back Pain*
Child
Female
Follow-Up Studies
Humans
Logistic Models
Male
Meningomyelocele / surgery
Motor Activity*
Neural Tube Defects / complications,  physiopathology*,  surgery*
Neurosurgical Procedures / adverse effects,  methods
Postoperative Complications / prevention & control*
Prognosis
Recovery of Function*
Retrospective Studies
Treatment Outcome
Comments/Corrections
Comment In:
J Neurosurg Pediatr. 2009 Jul;4(1):26-7; discussion 27   [PMID:  19569906 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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