Long-term evaluation of intraoperative neurophysiological monitoring-assisted tethered cord surgery

Autor: H. L. Journée, F. Lange, S. E. Dulfer, Gea Drost, Eelco W. Hoving, F. H. Wapstra
Přispěvatelé: Movement Disorder (MD)
Jazyk: angličtina
Rok vydání: 2017
Předmět:
Male
Intraoperative Neurophysiological Monitoring
CHILDREN
SYRINGOMYELIA
0302 clinical medicine
Tethered spinal cord surgery
Quality of life
LIPOMAS
YOUNG-ADULTS
Longitudinal Studies
Neural Tube Defects
Child
Follow-up
General Medicine
Treatment Outcome
medicine.anatomical_structure
Split cord malformation
Child
Preschool
030220 oncology & carcinogenesis
Anesthesia
Female
NEAR-TOTAL RESECTION
Neurosurgery
Myelomeningocele
Syringomyelia
medicine.medical_specialty
Adolescent
SPINA-BIFIDA
Scoliosis
03 medical and health sciences
RADICAL RECONSTRUCTION
Intra-operative neurophysiological monitoring
medicine
Humans
SCOLIOSIS
Lipomyelomeningocele
Retrospective Studies
Original Paper
SURGICAL OUTCOMES
business.industry
Spina bifida
Infant
Spinal cord
medicine.disease
Surgery
Pediatrics
Perinatology and Child Health
Orthopedic surgery
Quality of Life
Neurology (clinical)
business
NEURAL PLACODE
030217 neurology & neurosurgery
Intraoperative neurophysiological monitoring
Zdroj: CHILDS NERVOUS SYSTEM, 33(11), 1985-1995. SPRINGER
Child's Nervous System
ISSN: 0256-7040
Popis: PURPOSE: Patients with tethered spinal cord have been investigated for short-term effects after tethered spinal cord surgery in the past. However, little is known about the long-term effects in this patient group. In this retrospective, longitudinal, observational study, a patient sample of a previous report of 65 patients was reassessed to observe the long-term effects of intraoperative neurophysiological monitoring-assisted tethered cord surgery.METHODS: With the use of patient charts and a survey, patients were scored on four domains: (1) neurological deficits, (2) urological deficits, (3) pain symptoms, and (4) orthopedic deficits. Measurements were performed at four moments in time: (1) preoperatively, (2) postoperatively, (3) follow-up 1 (4.6 years), and (4) follow-up 2 (11.2 years). Besides this, a subgroup analysis and a quality of life questionnaire were performed.RESULTS: When observing the symptom domains in the long-term, the pain domain appeared to improve most postoperatively after which it remained stable over time. The neurological and urological domains showed a stable, slightly decreasing trend in the long-term follow-up. The orthopedic domain showed a significant increase of the number of patients with scoliosis during the long-term follow-up.CONCLUSIONS: Lasting effects of stability in the neurological, urological, and pain domains were observed. Close monitoring during follow-up might contribute to early recognition of progressive scoliosis, in spite of detethering, in a risk group defined by females who underwent tethered cord surgery at or under the age of 12 years old with either lipomyelomeningocele, split cord malformation, or myelomeningocele. Detethering does not appear to protect these patients against progressive scoliosis.
Databáze: OpenAIRE
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