Surgical treatments on adult tethered cord syndrome

Gao, Jun; Kong, Xiangyi; Li, Zhimin; Wang, Tianyu; Li, Yongning

doi:10.1097/md.0000000000005454

Cited by 16 publications

(4 citation statements)

References 18 publications

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“…[14] At present, surgical treatment is still the first choice for symptomatic adult patients. [7,15] Classical Untethering Surgery has been the gold standard to date. [15][16][17] The tension of the spinal cord was reduced by releasing the traction and fixation of the spinal cord through the thickening of the filum terminale.…”

Section: Discussionmentioning

confidence: 99%

“…However, surgery to treat symptomatic TCS during adulthood can be challenging and complicated. [6,7] In these cases, several kinds of malformations might also be diagnosed and should be treated in the meantime. Although it is unknown whether these malformations are the consequences of symptomatic adult TCS or the correction of the body to the unnormal anatomic structure, they should be corrected to some degree.…”

Section: Introductionmentioning

confidence: 99%

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Dekyphosis operation combined with limited osteotomy to treat the symptomatic adult tethered cord syndrome with complicated malformations: A case report

Ji¹,

Xiao²,

Wang³

et al. 2023

Medicine

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Rationale: Tethered cord syndrome (TCS) represents a spectrum of neurological symptoms that are caused by constant or intermittent axial traction of the terminal cone of the spinal cord due to abnormal positioning. It is uncommon for abnormal structures of TCS to be accompanied by split cord malformation, thoracic spinal stenosis, and other spinal cord diseases. Patient concerns: A 45-year-old male patient visited our hospital due to severe lower back pain, extensive left lower limb muscle weakness, and intermittent claudication. Diagnoses: TCS combined with stenosis of the thoracic canal, split cord malformation, and kyphosis deformity. Interventions: The patient underwent Dekyphosis operation combined with limited osteotomy symptoms. Outcomes: The patient felt the right lower limb improved after surgery. At 4-month follow-up, a radiological examination showed adequate decompression of the spinal cord and a good internal fixation position. Overall, the patient’s clinical symptoms significantly improved. Conclusion: This is a rare case of TCS combined with thoracic disc herniation and bony mediastinum. A more conservative invasive surgical approach was elected and markedly improved the patient’s symptoms. Additional clinical cases are needed to confirm the stability and feasibility of this surgical approach.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dekyphosis operation combined with limited osteotomy to treat the symptomatic adult tethered cord syndrome with complicated malformations: A case report

Ji¹,

Xiao²,

Wang³

et al. 2023

Medicine

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“…The most common symptoms are back pain, lower extremity weakness, sphincter dysfunction, and sciatica-type pain. In addition to neurological symptoms, the following may be present: skin stigmata, foot deformity, scoliosis of the thoracic and lumbar spine, muscular atrophy of the lower extremities [7][8][9]. According to O'Connor, by 2019, a total of only 730 cases of TCS in adults have been described [2].…”

Section: Introductionmentioning

confidence: 99%

Clinical analysis of tethered cord syndrome and gene expression profiling of wound healing surgery

Staszkiewicz¹,

Gładysz²,

Golec³

et al. 2023

pdia

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Introduction:The method to prevent progression of symptoms in tethered cord syndrome (TCS) is neurosurgery. However, postoperative wound healing is a lengthy process and is hindered by the release of cerebrospinal fluid (CSF) through the wound. To the best of the authors' knowledge, there is no study evaluating the changes in the expression of factors involved in the wound healing process after neurosurgery for TCS. Aim: To clinically analyse two cases of TCS and evaluate the change in expression of selected genes during the postoperative wound healing process. Material and methods: Determination of TCS in two adult patients (woman, aged 26 years; man, aged 53 years) was based on magnetic resonance imaging (MRI). After confirming the initial diagnosis, a neurosurgical procedure was performed to remove the intrathecal spreading adipoma and transect the medullary terminal thread in patients. In the postoperative period, impaired wound healing was noted as a result of CSF secretion through the surgical wound. Results: Molecularly, there was an increase in expression of all genes assessed in skin biopsy specimens compared to skin samples. Impaired postoperative wound healing after neurosurgery for TCS is expected due to CSF leakage through the surgical wound. The greatest changes were noted for metalloproteinases (MMPs) and four isoforms (A-D) of vascular endothelial growth factor A-D (VEGF-A-D; p < 0.05). Conclusions: Changes in the expression of our selected genes can be used to monitor and predict the process of wound healing and scar formation, which occurred in our cases at 19 and 20 days after surgery.

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“…In the article, “Surgical treatments on adult tethered cord syndrome: A retrospective study”, [ 1 ] which appeared in Volume 95, Issue 46 of Medicine , a sentence in the abstract, “A retrospective analysis of 82 adult patients (17 male cases, 82% and 24 female cases, 59%)…” appeared incorrectly and should have appeared as “A retrospective analysis of 82 adult patients (34 male cases, 41.5% and 48 female cases, 58.5%)…” In Table 1 , the totals in the Complete release and Partial release columns appeared incorrectly and should have appeared as seen in the table below.…”

mentioning

confidence: 99%