Spinal cord tethering and syringomyelia after trauma: impact of age and surgical outcome

Bratelj, Denis; Stalder, Susanne; Capone, Crescenzo; Jaszczuk, Phillip; Dragalina, Cristian; Pötzel, Tobias; Gebhard, Cathérine; Fiechter, Michael

doi:10.1038/s41598-023-38565-0

Cited by 2 publications

(1 citation statement)

References 29 publications

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“…Our results revealed that age was significantly associated with the occurrence of spinal cord tethering, with older patients being more likely to develop this complication. This finding is consistent with previous studies suggesting that age-related changes in spinal cord morphology and tissue elasticity may predispose older individuals to an increased risk of tethering following trauma [8][9][10] . Moreover, older age has been linked to decreased regenerative capacity and delayed healing, potentially exacerbating the severity of tethering and complicating surgical intervention.…”

Section: Discussionsupporting

confidence: 93%

Spinal Cord Tethering after Trauma and Impact of Age and Surgical Outcome

Khattak,

Ujjan,

Raza

et al. 2024

PJMHS

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Introduction: Spinal cord tethering, a condition where the spinal cord becomes attached or fixed to surrounding tissues, can occur following trauma, leading to a range of neurological deficits and complications. Objectives: The main objective of the study is to find the spinal cord tethering after trauma and impact of age and surgical outcome in local population of Pakistan. Material and methods: This retrospective study was conducted in Ayub Medical Complex Abbottabad from January 2023 to August 2023. Data was collected from 50 patients of spinal cord tethering patients. Data collection involved a comprehensive review of the medical records of patients. Relevant demographic information, including age at the time of trauma, gender, and comorbidities, was extracted. Clinical details such as mechanism of injury, level and severity of spinal cord injury, duration of symptoms and preoperative neurological status were documented. Results: Data were collected from 50 SCI patients. The mean age of the patients was 45 ± 10.5 years and there were 60% male and 40% female patients. The most common mechanisms of injury were motor vehicle accidents (50%), followed by falls (30%) and sports-related injuries (20%). Regarding the spinal level affected, the majority of injuries were cervical (60%), followed by thoracic (30%) and lumbar (10%). Neurological improvement was observed in 40% of patients, with complete improvement in 40% and partial improvement in 20%, while 40% showed no improvement. Complications were reported in a subset of patients, with cerebrospinal fluid leaks occurring in 15%, wound infections in 10%, and other complications in 5% of cases. Reoperation was necessary in 10% of patients, while 90% did not require further surgical intervention. Age and neurological improvement showed non-significant differences between groups (p > 0.05), while length of hospital stay differed significantly (p = 0.018). Complications and functional improvement did not vary significantly between groups (p > 0.05) Practical Implication: This study's practical implications offer vital benefits to the community. The identification of age as a critical component in spinal cord tethering after trauma enables healthcare practitioners to more accurately evaluate risk and customize therapies. Furthermore, our research emphasizes how successful surgical therapies are for patients of all ages, giving patients confidence in their available treatment alternatives. Further improving patient care is pushing for individualized treatment options and being aware of related consequences. Conclusion: It is concluded that age influences the occurrence of spinal cord tethering following trauma, with older patients being more susceptible to this complication. However, surgical intervention appears to be equally effective across age groups, with comparable rates of neurological improvement and complications. Keywords: Spinal cord tethering, Trauma, Age impact, Surgical outcome, Neurological improvement, Complications

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Section: Discussionsupporting

confidence: 93%

Spinal Cord Tethering after Trauma and Impact of Age and Surgical Outcome

Khattak,

Ujjan,

Raza

et al. 2024

PJMHS

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Cauda equina syndrome due to posttraumatic syringomyelia in conus medullaris – A case report

Ueda,

Yamamoto,

Koga

et al. 2024

Surgical Neurology International

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Background: Most posttraumatic syringomyelias occur in the cervical or thoracic spinal cord, where they contribute to myelopathic deficits. Here, a 40-year-old patient presented with the left leg monoparesis due to syringomyelia involving the conus medullaris 10 years after an L2 vertebral “crush” fracture. Case Description: Ten years following an L2 vertebral “crush” fracture, a 40-year-old male presented with the new onset of left lower leg paresis. The magnetic resonance imaging showed a T12–L1 syrinx associated with accompanying high-intensity areas above the syrinx located between the T11 and T12 levels. One month after placing a syringosubarachnoid (SS) shunt, both the syrinx and high-intensity area rapidly disappeared, and the left distal motor weakness resolved. Conclusion: Ten years following an L2 “crush” fracture, a 40-year-old male presented with the new onset of a cauda equina syndrome secondary to a posttraumatic T12–L1 syringomyelia causing expansion of the conus medullaris.

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Spinal cord tethering and syringomyelia after trauma: impact of age and surgical outcome

Cited by 2 publications

References 29 publications

Spinal Cord Tethering after Trauma and Impact of Age and Surgical Outcome

Spinal Cord Tethering after Trauma and Impact of Age and Surgical Outcome

Cauda equina syndrome due to posttraumatic syringomyelia in conus medullaris – A case report

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