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Surgical Outcome of Children and Adolescents with Tethered Cord Syndrome

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Title: Surgical Outcome of Children and Adolescents with Tethered Cord Syndrome
Authors: Seki, Toshitaka Browse this author
Hida, Kazutoshi Browse this author
Yano, Shunsuke Browse this author
Sasamori, Toru Browse this author →KAKEN DB
Hamauch, Shuji Browse this author
Koyanagi, Izumi Browse this author
Houkin, Kiyohiro Browse this author →KAKEN DB
Keywords: Children
Spina bifida
Issue Date: Oct-2016
Publisher: Korean Society of Spine Surgery
Journal Title: Asian spine journal
Volume: 10
Issue: 5
Start Page: 940
End Page: 944
Publisher DOI: 10.4184/asj.2016.10.5.940
Abstract: Study Design: Retrospective cohort study. Purpose: To compare long-term results of surgery with the outcomes of symptomatic and asymptomatic tethered cord syndrome (TCS) in children and adolescents and to assess the surgery duration for those with TCS. Overview of Literature: Pediatric patients with TCS continue to pose significant diagnostic and management challenges. Methods: We retrospectively analyzed the outcomes of 31 patients (16 males, 15 females) with TCS, including 21 with lumbosacral lipoma. All were surgically treated between 1989 and 2015. They were divided into symptomatic and asymptomatic TCS groups. The results of the treatment were summarized and analyzed using a non-parametric Mann-Whitney U test. Results: Nineteen patients had symptomatic TCS and 12 had asymptomatic TCS. Patients had a median age of 34 months (range, 0-201 months). The median follow-up period was 116 months (range, 7-223 months). Of the 19 symptomatic TCS patients, preoperative deficits improved after surgery in two (10.5%) and remained stable in 17 (89.5%) patients. One of the 12 asymptomatic TCS (8.3%) patients showed an exacerbated illness after surgery, and one in 11 patients remained stable (11.7%). There were significant differences in monthly age at surgery, preoperative bowel and bladder dysfunction, neurological function, presence/absence of clean intermittent catheterization introduction, and presence/absence of motor disorder at final follow-up (all p<0.05). In the univariate analysis, the presence/absence of preoperative bowel and bladder dysfunction, and symptoms were strongly associated with the risk of children and adolescents with TCS (p<0.05). Conclusions: Early accurate diagnosis and adequate surgical release might lead to successful outcomes in children and adolescents with TCS. Surgical untethering is a safe and effective method for treatment of children with TCS.
Type: article
Appears in Collections:北海道大学病院 (Hokkaido University Hospital) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 関 俊隆

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