Tethered cord syndrome: surgical outcome of 43 cases and review of literatures

Elmesallamy, Wael Abd Elrahman Ali; AbdAlwanis, Atef; Mohamed, Sami

doi:10.1186/s41984-019-0029-8

Cited by 9 publications

(4 citation statements)

References 24 publications

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“…A variety of things were determined to be the cause. [26] Only three patients in our study needed expansileduraplasty because to persistent infections and leaks. Another consequence of spinal dysraphism is tying the rope, in which patients with neurological signs that develop adhesion at the repair site and subsequently, although such difficulties were perhaps not observed owing to the short follow-up time.…”

Section: Discussionmentioning

confidence: 86%

The Incidence and Treatment of Cerebrospinal Fluid Leakage Following Repair of Congenital Spinal Pathologies

Ahmed¹,

Khalil²,

Khan³

et al. 2022

PJMHS

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Objective: The study's goal is to find out how often individuals with myelomeningocele and TCS repair have leakage of cerebrospinal fluid. Study Design: Cross-sectional Place and Duration: Women medical college Abbottabad and Children hospital and the institute of child health, Multan, during from the period July, 2021 to Dec, 2021. Methods: There were 55 participants of both sexes in this research. Those being treated ranged in age from 5 to 20 years old. After obtaining written permission, we collected demographic data on each patient, including their age, gender, and BMI measurements. There were patients who had TCS repair as well as those who had undergone myelomeningocele repair procedures. It was determined how often cerebrospinal fluid leaks occurred in patients. SPSS 22.0 was used to analyze all of the data. Results: Among 55 cases, majority were males 32 (58.2%) and 23 (41.8%) were females. Included patients had mean age 9.5±6.14 years. Frequency of CSF leak was found among 18 (32.7%) patients. The mean duration of CSF leaks was 13.11±10.34 days. In 18 patients of CSF leaks, Frequency of MMC repair was 11, TCS release was found in 3 patients and meningocele repair in 4 patients. With the use of tincture benzoyl-enhanced primary wound healing in three patients with CSF leaks during surgery, the HCP postoperative signs were resolved. HCP was found in two further patients after their sutures mended with benzoyl tinctures, and they were placed in the shunt. Conclusion: In this research, we found that CSF leaks are more common in patients having myelomeningocele and TCS repair. Skin-healing tincture benzoyl will help these people. Keywords: Cerebrospinal fluid leak (CSF), Tether cord syndrome (TCS), Myelomeningocele (MMC)

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Section: Discussionmentioning

confidence: 86%

The Incidence and Treatment of Cerebrospinal Fluid Leakage Following Repair of Congenital Spinal Pathologies

Ahmed¹,

Khalil²,

Khan³

et al. 2022

PJMHS

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“…Fone et al 26 found no change in compliance. Elmesallamy 27 reported the 73% improvement in urodynamic studies after detethering. The utility of urodynamic studies in assessing the bladder function on preoperative and postoperative periods is invaluable and accuracy of these studies is more when compared with renal ultrasound and serial cystometrography.…”

Section: Discussionmentioning

confidence: 99%

A Study of Outcome of Detethering in Delayed Presentation of Tethered Cord Syndrome

Beniwal,

K.,

et al. 2024

Indian Journal of Neurosurgery

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Introduction Tethered cord syndrome (TCS) is a stretch-induced functional disorder associated with tethering of caudal spinal cord to dura mater with inelastic tissue, limiting its movement. It not only manifests in childhood but also noted in adults. Here, we studied the role of detethering on delayed presentation of TCS. Material and Methods All patients of symptomatic TCS from January 2011 to December 2019 were included. Preoperative evaluation was done through X-ray; ultrasonography kidney, ureter, urinary bladder; magnetic resonance imaging spine and brain; and urodynamic studies. Detethering was done and associated pathology was excised. Preoperative and postoperative comparison was done through Necker functional score using chi-squared system. Results Age range was 8 to 30 years with mean age of 13.8 years. Most common presentation was urological manifestations in ∼61.1% of cases followed by pain in 41.6%, sensory deficits in 38.8%, asymmetric weakness in 30.5%, orthopaedic and trophic ulcers in 22.2% each, and bowel abnormalities in 13.8% of cases. Mean duration of symptoms was 5.52 years. Improvement in urological manifestations was in 71.4% patients, pain in 80%, sensory dysfunctions in 71.4%, bowel dysfunctions in 80%, motor weakness in 90.9%, and trophic ulcer in 100% patients. On comparison, chi-squared value was 25.9993 and p-value was 0.000032, which was significant (<0.05). Conclusion Detethering in early ages is already proven with good results. In our study, detethering showed statistically significant improvement even in delayed presentation. So, authors recommend to surgically interfere by detethering, even if tethering is detected late with significant deficits.

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“…Urodynamic tests improved in 73% of adults following surgery, and children improved significantly in all cases. 20 Each etiology of TCS necessitates a unique set of surgical treatments, ranging from simple filum release to sophisticated lipomyelomeningocele excision and release. Surgical site infection (SSI) and cerebrospinal fluid (CSF) leaking are the most prevalent consequences following TCS surgery, regardless of the underlying condition.…”

Section: Discussionmentioning

confidence: 99%

Frequency of SCF Leakage in Post-operative Patients of Tethered Spinal Cord in A Tertiary Care Hospital

et al. 2022

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Objective: The study aimed to report the incidence of CSF leakage in patients with a tethered spinal cord, post-operatively. Materials and Methods: A total of 75 individuals aged more than 2 years and of either gender who were hospitalized for surgery for tethered cord syndrome were included. All patients had a preoperative MRI of the spine, and those above the age of 6 had urodynamic tests. Clinical evaluations were performed until hospital release, then again at 3, 6, and 12 months. Urodynamic tests and spine MRIs were redone one year following surgery. Under general anesthesia, all patients had microscopic untethering procedures to release tethering materials and heal the thecal sac. Results: 52% of patients fall under TCS type ‘simple’, whereas, 48% of patients found with complex TCS. The frequency of CSF leakage in post-operative patients with a tethered spinal cord was found in 17.33%. No CSF leak was reported in the majority of patients (49%) patients in the age group 2-30 years. 52% of patients with simple TCS reported no CSF leak, whereas, only 13(18%) patients with complex TCS reported CSF leaks. 40% of patients reported no CSF leak who was diagnosed with complex TCS. There existed a significant relationship between the types of TCS (simple/complex) for CSF leak distribution. Conclusion: This study concluded that the frequency of CSF leakage in post-operative patients with tethered spinal cord was found in 17.33% of patients. Keywords: Tethered Spinal Cord (TCS), CSF Leakage, Lipomyelomeningocele.

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Tethered cord syndrome: surgical outcome of 43 cases and review of literatures

Cited by 9 publications

References 24 publications

The Incidence and Treatment of Cerebrospinal Fluid Leakage Following Repair of Congenital Spinal Pathologies

The Incidence and Treatment of Cerebrospinal Fluid Leakage Following Repair of Congenital Spinal Pathologies

A Study of Outcome of Detethering in Delayed Presentation of Tethered Cord Syndrome

Frequency of SCF Leakage in Post-operative Patients of Tethered Spinal Cord in A Tertiary Care Hospital

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