Factors affecting the surgical outcomes of tethered cord syndrome in adults: a retrospective study

Abdallah, Anas; Emel, Erhan; Abdallah, Betül Güler; Asiltürk, Murad; Sofuoğlu, Özden Erhan

doi:10.1007/s10143-017-0842-z

Cited by 28 publications

(22 citation statements)

References 21 publications

(36 reference statements)

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“…Our female patient had the same transit glob (retention of urination); however, she improved, as shown in Table 3 . Our review of the literature found that several studies suggested age, histology, previous surgery, tumor size, location, tumor consistency, and the extent of resection are not correlated with surgical morbidity, while removing 2 or more laminae can lead to spinal deformity, especially in children [ 8 , 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…All the spinal ependymoma cases of children (patients age of under 18 years) are included in the current study (n=3). The patient characteristics, clinical presentation, surgical findings, and pre- and post-operative neurological functional assessments were evaluated using a modified neurological scoring system ( Table 1 ) [ 8 ], and long-term outcome are discussed. The relevant literature concerning ependymomas in children is also reviewed.…”

Section: Methodsmentioning

confidence: 99%

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Pediatric Spinal Ependymomas

Sofuoğlu

Abdallah

2018

Med Sci Monit

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BackgroundThe aim of this study was to assess the clinical and radiological outcomes of surgical treatment for primary spinal ependymoma in children.Material/MethodsMedical records of 46 primary spinal ependymoma patients who underwent surgery in BRSHH hospital during a 12-year period from 2004 to 2015 were retrospectively reviewed. All pediatric patients (patient age <18 years) were selected as the core sample used for this study.ResultsThis series included 1 female and 2 male patients between the ages of 9 and 17 years with mean age 13.3±3.9 years. The mean preoperative course was 9.1±10.5 months. The most common location was the lumbar spinal cord (n=2). The most common presenting symptoms was lower-limb weakness and numbness. Two tumors were located intradural-intramedullary and 1 was located intradural-extramedullary. Gross-total resection (GTR) was achieved in 2 patients, and a near-total resection was performed in 1 patient. No adjuvant treatment was received. The mean follow-up duration was 51.3±37.6 (17–98) months. No complications were recorded. Functional assessment of all patients by the latest follow-up evaluation showed good progress even though the patient is not fully recovered. At 6.3 years after the first operation, 1 patient presented with drop-seeding metastasis. No patients had neurofibromatosis type 2.ConclusionsLaminoplasty and intraoperative neurophysiological monitorization are essential in surgical treatment of pediatric spinal ependymomas. GTR and recovery in pediatric spinal ependymoma are more likely than in adults. Despite the GTR, the risk of drop metastasis remains. Therefore, close clinical and radiological follow-up is recommended.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Pediatric Spinal Ependymomas

Sofuoğlu

Abdallah

2018

Med Sci Monit

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“…Compared to patients diagnosed at childhood, they exhibit more tolerance to certain symptoms. [ 24 ] When the spinal conus medullaris and nerve roots are affected, the patients suffer back pain, lower limbs weakness, foot deformities, spinal scoliosis, missing sensation, or bladder or rectum dysfunction. [ 22 , 23 , 25 – 27 ] The neurologic dysfunction occurring in adulthood is usually irreversible.…”

Section: Discussionmentioning

confidence: 99%

Spinal cord infarction caused by sacral canal epidural steroid injection

et al. 2018

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Rationale:Spinal cord infarction is one of the complications of epidural steroid injections (ESIs), but has only been reported in cervical vertebra by transforaminal injection and lumbar vertebra by transforaminal injection; and up to now, there is no reporting about spinal cord infarction caused by caudal injection. Here, we report a case.Patient concerns:A 52-year-old man was admitted to our hospital. He was diagnosed as lumbar disc herniation in other hospital, and the patient suffered bilateral lower limb motor and sensory disorders after administration of caudal ESI.Diagnosis:Spinal cord infarction, tethered cord syndrome (TCS), and acute myelitis.Interventions:High doses of hormones, gamma globulin impact therapy, and rehabilitation were performed.Outcomes:The patient's condition was stable when he discharged from the hospital after 20 days of treatment. Discharge status: grade 0 of bilateral lower limbs muscle strength, inability to urinate and defecate by himself, slightly decreased touch, and needling sensation below the umbilical plane.Lessons:When patients are diagnosed with lumbar disc herniation and need to receive invasive treatments, magnetic resonance imaging (MRI) should be performed before the invasive procedures.

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“…Patient characteristics, clinical presentation, surgical findings, pre-and postoperative neurological functional status, complications, and treatment outcomes were discussed. Pre-and postoperative neurological functional assessments had been evaluated using a modified neurological scoring system (Table 1) [9]. The neurological scoring system was introduced by Klekamp and Samii [10] in 1993 before being modified by Abdallah et al [9] in 2018 using urodynamic studies.…”

Section: Patient Data and Study Designmentioning

confidence: 99%

“…Pre-and postoperative neurological functional assessments had been evaluated using a modified neurological scoring system (Table 1) [9]. The neurological scoring system was introduced by Klekamp and Samii [10] in 1993 before being modified by Abdallah et al [9] in 2018 using urodynamic studies. The relevant literature concerning SSM in primary pediatric spinal MPEs was also briefly reviewed.…”

Section: Patient Data and Study Designmentioning

confidence: 99%

Spinal Seeding Metastasis of Myxopapillary Ependymoma: Report of Three Pediatric Patients and a Brief Literature Review

Abdallah¹

2020

Pediatr Neurosurg

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Objective: Myxopapillary ependymomas (MPEs) in children are rarely reported low-grade glial tumors; however, MPEs sometimes possess malignant characteristics such as spinal seeding/drop metastasis (SSM). We aimed to present 3 pediatric MPE cases that experienced SSM at 2 neurosurgical centers. Materials and Methods: We retrospectively reviewed the medical records of 38 primary spinal MPE cases who underwent surgery at 2 neurosurgical centers spanning 16 years, from 2004 to 2019. All pediatric cases (patient age < 18 years) who were diagnosed with MPE and represented with SSM were selected as the core sample for this study. Relevant literature was briefly reviewed. Results: Three pediatric MPE cases (2 females and 1 male) experienced SSM. The mean age at first presentation was 12.0 ± 1.0 years. The mean preoperative course was 2.9 ± 1.2 months. The predominant location was the lumbar spine in 2 tumors (both originated from terminal filum [TF]). Two tumors were located intradural intramedullary. Gross-total resection was achieved in 2 patients. No patient had neurofibromatosis type 2. No adjuvant treatment was given after the first surgery. The mean period between the first diagnosis and diagnosis of SSM was 44.0 ± 31.5 months. The location of SSM in all patients was the sacral spine (1 patient experienced distant metastasis in her brain besides her sacral metastasis). The mean follow-up was 68.3 ± 53.7 months. Conclusions: We found a statistically significant relationship between SSM in pediatric MPEs and the intramedullary location, TF origin, and number of affected segments. Close clinical and radiological follow-up is essential for pediatric MPE patients.

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Factors affecting the surgical outcomes of tethered cord syndrome in adults: a retrospective study

Cited by 28 publications

References 21 publications

Pediatric Spinal Ependymomas

Pediatric Spinal Ependymomas

Spinal cord infarction caused by sacral canal epidural steroid injection

Spinal Seeding Metastasis of Myxopapillary Ependymoma: Report of Three Pediatric Patients and a Brief Literature Review

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