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Functional improvement after spinal surgery for the dysraphic malformations

M Linder, J Rosenstein, F H Sklar

    Neurosurgery
    |November 1, 1982
    PubMed
    Summary

    Spinal surgery effectively treats spinal dysraphic malformations, particularly hydromyelia and pain, offering excellent prognoses. Surgical intervention aims to halt disease progression and improve patient outcomes.

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    Area of Science:

    • Neurosurgery
    • Pediatric Neurology
    • Spinal Cord Medicine

    Background:

    • Spinal surgery is crucial for managing spinal dysraphic malformations.
    • Prognosis varies significantly based on clinical presentation and specific malformation.
    • Identifying factors predicting surgical success is essential for patient management.

    Purpose of the Study:

    • To evaluate the surgical outcomes in patients with spinal dysraphic malformations.
    • To identify specific clinical conditions associated with favorable surgical prognoses.
    • To assess the efficacy of surgery in improving neurological, urological, and pain symptoms.

    Main Methods:

    • Retrospective analysis of 55 patients undergoing 69 spinal surgical procedures.
    • Diagnoses included hydromyelia, tethered cord (diastematomyelia, lipoma, lipomeningocele, previous operation, thickened filum terminale).

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  • Outcomes assessed for functional neurological, urological, and pain improvement.

    • Main Results:

    • Pain relief achieved in 92% of patients with preoperative pain.
    • Significant functional return observed in 67% of hydromyelia patients.
    • Tethered cord surgery showed improvement rates from 24% (lipoma) to 46% (thickened filum/diastematomyelia).

    Conclusions:

    • Patients with hydromyelia and those with spinal dysraphic malformations presenting with pain have an excellent surgical prognosis.
    • These findings suggest a need to re-evaluate surgical indications for specific patient groups.
    • Optimizing surgical timing and patient selection can lead to better outcomes in spinal dysraphism treatment.