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Delayed postoperative tethering of the cervical spinal cord
1Division of Neurological Surgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, Arizona.
Journal of Neurosurgery
|August 1, 1994
Summary
Delayed cervical spinal cord tethering after surgery is rare but can cause severe symptoms. Surgical detethering offers favorable outcomes, with duraplasty recommended to prevent recurrence.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Spinal Cord Disorders
Background:
- Spinal cord tethering is common in the lumbar and sacral regions in children with congenital anomalies.
- Cervical spinal cord tethering is infrequently reported, and symptomatic postoperative cases are exceptionally rare.
Observation:
- The authors report five cases of delayed symptomatic cervical spinal cord tethering presenting 1–31 years postoperatively.
- Patients experienced severe headache, upper-extremity pain, and progressive neurological deficits.
- Magnetic resonance imaging confirmed dorsal cervical cord tethering in all cases.
Findings:
- Surgical exploration and microscopic sharp detethering of the cervical cord were performed.
- All five patients showed favorable results after the detethering procedure.
- Wide Tutoplast duraplasty was employed to prevent retethering.
Implications:
- This study highlights delayed cervical spinal cord tethering as a potential complication of spinal surgery.
- Microscopic detethering and duraplasty are effective in managing symptomatic cervical spinal cord tethering.
- Further research into the long-term efficacy of duraplasty in preventing retethering is warranted.