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The tethered spinal cord: its protean manifestations, diagnosis and surgical correction
Child'S Brain
|January 1, 1976
Insights
Tethered spinal cord release in children with spina bifida occulta effectively treated back pain and neurogenic bladder. Surgical intervention also frequently corrected scoliosis and improved lower limb deformities.
Area of Science:
- Pediatric Neurosurgery
- Spinal Surgery
- Developmental Pediatrics
Background:
- Spina bifida occulta is a congenital condition that can lead to significant neurological and orthopedic complications.
- Tethered spinal cord is a common cause of these complications in children with spina bifida occulta.
- Symptoms include back pain, scoliosis, progressive neurological deficits, and neurogenic bladder.
Purpose of the Study:
- To evaluate the efficacy of surgical release of tethered spinal cord in children with spina bifida occulta.
- To assess the impact of surgical intervention on presenting symptoms such as pain, scoliosis, neurological deficits, and bladder function.
Main Methods:
- Retrospective analysis of 31 children diagnosed with spina bifida occulta and tethered spinal cord.
- Surgical release of the tethered spinal cord was performed.
- Outcomes were assessed based on the resolution or improvement of back pain, scoliosis, lower limb neurological deficits, and neurogenic bladder.
Main Results:
- Surgical release of the tethered spinal cord consistently relieved back pain in all patients.
- Progressive scoliosis was frequently corrected following surgical intervention.
- Neurogenic foot deformities and neurogenic bladder function showed arrest or improvement post-surgery.
Conclusions:
- Surgical release of a tethered spinal cord is a highly effective treatment for children with spina bifida occulta presenting with pain, scoliosis, neurological deficits, or bladder dysfunction.
- The procedure offers significant benefits in managing the complex orthopedic and neurological sequelae of this condition.
Abstract:
31 children with spina bifida occulta who have presented with back pain, scoliosis, a progressive neurological deficit involving lower limbs or a neurogenic bladder have been found to have a tethered spinal cord. Release of the tethered spinal cord has always relieved pain, frequently occrected a progressive scoliosis, and arrested or improved neurogenic foot deformities as well as neurogenic bladder.