Improved symptoms and lifestyle more than 20 years after untethering surgery for primary tethered cord syndrome

Fukui, Jun; Ohotsuka, Kuniyoshi; Asagai, Yoshimi

doi:10.1002/nau.21176

Cited by 6 publications

(12 citation statements)

References 13 publications

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“…After applying all inclusion/exclusion criteria, seven studies were eligible for inclusion : five studies on urological outcomes after untethering in adults with primary CSD , one on adult patients before surgery , and one long‐term follow‐up after surgery in childhood . Figure shows the selection process.…”

Section: Resultsmentioning

confidence: 99%

“…All were retrospective cohorts and case series, and are discussed below. Outcomes are also shown in Table .…”

Section: Resultsmentioning

confidence: 99%

“…The age given of the study by Fukui et al. is in fact the age at time of follow‐up, as all children were operated during childhood. † Follow‐up in entire cohort.…”

Section: Resultsmentioning

confidence: 99%

“…Of the seven studies, five (with 52 patients) described surgery of CSD during adulthood with a mean age at surgery of 35.8 years. One study described long‐term outcomes of surgery for CSD during childhood ; the mean age at surgery in this study was 12.7 years. Findings at physical (neurological) examination were only properly reported by one author .…”

Section: Resultsmentioning

confidence: 99%

“…Bladder pressures were never provided. Methods of bladder emptying and urological management were only briefly mentioned in most studies, and described in 38 patients only (two studies) . Clean‐intermittent catheterisation (CIC) was performed in 12/38 patients, 19/33 patients voided spontaneously, two of 33 used abdominal straining, and two of 33 did the Credé manoeuver.…”

Section: Resultsmentioning

confidence: 99%

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Paucity of evidence for urinary tract outcomes in closed spinal dysraphism: a systematic review

et al. 2013

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Objectives• To describe the long-term upper (UUT) and lower urinary tract (LUT) outcomes in patients with closed spinal dysraphism (CSD). • CSD differs from open spinal dysraphism (OSD) by its long asymptomatic course and consequent later diagnosis. The outcome of UUT and LUT function in adults with CSD is relatively unknown. Patients and Methods• A systematic review was performed following the standards of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. An extensive search was made of PubMed and EMBASE.• Included were papers on adults with any form of primary CSD that described bladder and/or kidney function. Only English and Dutch language papers were included. Excluded were papers on patients aged <18 years and patients with secondary tethered cord following childhood OSD repair. International Continence Society terminology was used to describe LUT outcomes. Results• Eventually, only seven studies (90 patients) were included and none of these described renal outcomes. Five of the seven papers were on outcomes after untethering surgery during adulthood.• Urological complaints were present in 54/79 (68.4%) patients.• Urodynamic studies (48 patients available) revealed detrusor underactivity in 46.5% of the evaluated cases, detrusor overactivity in 32.6% and normal findings in 16.3% of the studied patients.• Symptomatic improvement after surgery for tethered cord occurred in 33.3-90.0%, depending on the subgroup studied. Urodynamic improvement rates ranged from 11.1% to 54.5% (but based on three studies with only 24 patients). Success of surgery depended on the time between onset of symptoms and operation, and (sometimes) type of lesion. Conclusions• Few data are available on long-term urological outcomes in adult patients with CSD.• More extensive research on follow-up, including the functional status of the UUT, is recommended.• Based upon the little evidence available, we think life-long follow-up (from birth into adulthood) of those with CSD and neurogenic bladder is advisable.

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Section: Resultsmentioning

confidence: 99%

“…All were retrospective cohorts and case series, and are discussed below. Outcomes are also shown in Table .…”

Section: Resultsmentioning

confidence: 99%

“…The age given of the study by Fukui et al. is in fact the age at time of follow‐up, as all children were operated during childhood. † Follow‐up in entire cohort.…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

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