Outcome in 32 cases of tethered cord in adults—is intervention justified?
Autor: | Sandip Chatterjee, Rahul Saha |
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Rok vydání: | 2020 |
Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Radiography Kyphosis General Medicine Scoliosis medicine.disease 030218 nuclear medicine & medical imaging Surgery 03 medical and health sciences 0302 clinical medicine medicine.anatomical_structure Intervention (counseling) Pediatrics Perinatology and Child Health medicine Sphincter Neurology (clinical) Neurosurgery business Neurophysiological Monitoring 030217 neurology & neurosurgery Reduction (orthopedic surgery) |
Zdroj: | Child's Nervous System. 37:195-202 |
ISSN: | 1433-0350 0256-7040 |
Popis: | Adults rarely present with tethered cord syndrome, and this review examines whether it is justifiable to perform surgical intervention in this group. Between 2003 and 2017, we performed surgical intervention in 32 adults with tethered cord syndrome. The age range varied from 22 to 65 years. Twenty-six had pain, 20 had motor deficits, and 18 had sensory deficits, whereas 17 presented with sphincter disturbances. Three had undergone surgery for meningomyelocele as infants. Six patients had major spinal deformity in the shape of kyphosis or scoliosis. All patients underwent digital radiographs and MR scans of the whole spine. The oldest with a leaking open meningocele was 41 years old. The mean follow-up was 3.2 years. Twenty-one out of 26 patients presenting with pain had their VAS scores improve significantly; 14 had motor deficits which improved. However, sensory deficits got better in only 7 out of 18 patients, and sphincter improvement was documented (via urodynamics studies and bladder ultrasound) in only 4 out of 17 patients. In 15 cases, surgery was performed under neurophysiological monitoring, and overall improvement was documented in 11 of these patients compared with 7 of the remaining 17 patients. Surgery for spinal deformity was performed in 6 patients, and deformity correction as well as pain reduction was achieved in all. Surgery leads to significant reduction of pain by untethering and in those with spinal deformity by correction of the same. Improvement in sensory changes and sphincter problems occurred in few patients. Neuromonitoring certainly has improved our results. |
Databáze: | OpenAIRE |
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