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Walking recovery after tethered cord release
Mohamed Ar AbdelFatah1, Aly Ibrahim2, Sameh Hefny2
1Neurosurgery Department, Faculty of Medicine, Ain Shams University, Cairo, Egypt. mohamed_abdelrahman@med.asu.edu.eg.
Neurosurgical Review
|June 24, 2024
Summary
Tethered spinal cord release after myelomeningocele repair can restore walking ability. Higher preoperative conus levels (S2-S3) predict better walking recovery one year post-surgery.
Area of Science:
- Neuroscience
- Pediatric Surgery
- Spinal Cord Medicine
Background:
- Secondary tethered spinal cord is common after myelomeningocele (MMC) repair.
- Tethered spinal cord can lead to neurological decline and impaired walking.
Purpose of the Study:
- To evaluate walking recovery one year after tethered cord release.
- To determine the relationship between preoperative conus level and walking recovery.
Main Methods:
- Retrospective cohort study of 37 patients undergoing spinal cord untethering post-MMC repair.
- Assessment of walking recovery using the modified Benzel scale one year after surgery.
- Analysis of preoperative conus vertebral levels (L4-S3).
Main Results:
- 37.8% of patients regained walking ability one year after tethered cord release.
- All patients with preoperative conus levels at S2 or S3 regained walking ability.
- No patients with preoperative conus levels at L4 or L5 regained walking ability; 33.3% at S1 regained function.
Conclusions:
- Walking recovery after tethered cord release is significantly associated with the preoperative conus level.
- Higher conus levels (S2-S3) correlate with successful walking recovery.
- Further multicenter prospective studies are needed to validate these findings.
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