Journals / Annals of Medical Research / 2018 / Cilt: 25 - Sayı: 3

Surgery for tethered cord syndrome: when and how?

Pages
503–510
Publication Date
2022-10-12
DOI
—
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AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

Firstly, a brief description of TCS will be provided, then an extensive view on the surgical treatment of TCS will be performed.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Tethered cord syndrome (TCS) is a clinical condition presented with neurological and/or urological signs and findings.
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Key Findings & Data:Increased hypoxic stress in the spinal cord secondary to traction or stretching is the pathophysiological mechanism of TCS.
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Conclusion & Impact:Firstly, a brief description of TCS will be provided, then an extensive view on the surgical treatment of TCS will be performed.
🔬Design:Review & Systematic Survey
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Tethered cord syndrome (TCS) is a clinical condition presented with neurological and/or urological signs and findings. Increased hypoxic stress in the spinal cord secondary to traction or stretching is the pathophysiological mechanism of TCS. It is usually observed in childhood but adult cases were also reported. Its diagnosis and treatment are always challenging. Magnetic resonance imaging, electrophysiological and urodynamic studies are the main diagnostic tools for TCS. This syndrome may be primary or secondary to previous surgeries such as myelomeningocele. Asymptomatic patients with low conus medullaris and thick filum terminale are always questionable for surgical treatment. On the other hand, symptomatic patients with normal radiological imaging are critical for surgical decision. Surgical treatment involves correction of the spinal pathologies and release of the spinal cord by cutting the filum terminale. Time of surgery and technical nuances are still in debate among neurosurgeons. Neurological andurological outcomes of the patients usually depend on these factors. Timing of surgery and surgical technique need to be clarified based on the recent clinical studies. This review will focus on the time and technique of TCS surgery. Firstly, a brief description of TCS will be provided, then an extensive view on the surgical treatment of TCS will be performed.

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Cite This Article

YAŞAR, S., KAYHAN, S., KAPLAN, A., KİRMİZİGOZ, Ş., İZCİ, Y., DOĞAN, A., KURAL, C. (2022). Surgery for tethered cord syndrome: when and how?. Annals of Medical Research, Cilt: 25 - Sayı: 3, 503–510. https://ajindex.com/articles/447334

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References (12)

  1. Samuels R, McGirt MJ, Attenello FJ, et al. Incidence of symptomatic retethering after surgical management of pediatric tethered cord syndrome with or without duraplasty. Childs Nerv Syst. 2009;25:1085-9.
  2. Ohe N, Futamura A, Kawada R, et al. Secondary tethered cord syndrome in spinal dysraphism. Childs Nerv Syst. 2000;16:457-61.
  3. Colak A, Pollack IF, Albright AL. Recurrent tethering: a common long-term problem after lipomyelomeningocele repair. Pediatr Neurosurg. 1998;29:184-90.
  4. Ostling LR, Bierbrauer KS, Kuntz C 4th. Outcome, reoperation, and complications in 99 consecutive children operated for tight or fatty filum. World Neurosurg. 2012;77:187-91. Kestle JR. Retethering after filum cutting. World Neurosurg. 2012;77:82. Vassilyadi M, Tataryn Z, Merziotis M. Retethering in children after sectioning of the filum terminale. Pediatr Neurosurg. 2012;48:335-41.
  5. Ogiwara H, Lyszczarz A, Alden TD, et al. Retethering of transected fatty filum terminales. J Neurosurg Pediatr. 2011;7:42-6.
  6. Yong RL, Habrock-Bach T, Vaughan M, et al. Symptomatic retethering of the spinal cord after section of a tight filum terminale. Neurosurgery. 2011;68:1594-601.
  7. Wang AC, Than KD, Etame AB, et al. Impact of anesthesia on transcranial electric motor evoked potential monitoring during spine surgery: a review of the literature. Neurosurg Focus 2009;27:E7. Beyazova M, Zinnuroglu M, Emmez H, et al. Intraoperative neurophysiological monitoring during surgery for tethered cord syndrome. Turk Neurosurg 2010;20:480-4.
  8. Yılmaz A, Özdemir B, Altaş K, et al. Intraoperative neurophysiologic monitoring in patients with tethered cord syndrome: clinical experience in thirty patients. The Medical Bulletin of Şişli Etfal Hospital. 2017;51:43-7.
  9. Maurya VP, Rajappa M, Wadwekar V, et al. Tethered cord syndrome-A study of the short-term effects of surgical detethering on markers of neuronal injury and electrophysiologic parameters. World Neurosurg. 2016;94:239-47.
  10. Pusat S, Kural C, Solmaz I, et al. Comparison of electrophysiological outcomes of tethered cord syndrome and spinal intradural tumors: A retrospective clinical study. Turk Neurosurg. 2017;27:797-803.
  11. Gao J, Kong X, Li Z, et al. Surgical treatments on adult tethered cord syndrome: A retrospective study. Medicine (Baltimore). 2016;95:e5454. Lin W, Xu H, Duan G, et al. Spine-shortening osteotomy for patients with tethered cord syndrome: a systematic review and metaanalysis. Neurol Res. 2018;40:340-63.
  12. Grande AW, Maher PC, Morgan CJ, et al. Vertebral c