ReviewChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2013
Recurrent tethered cord: radiological investigation and management.
Review in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 29 citations in OpenAlex.
- Acupuncture as an Adjuvant Therapy for Tethered Cord Syndrome: A Case Report.Medical acupuncture · 2026Article
- Recurrent tethered cord: outcome and follow-up of 20 de-thetering for symptomatic spina bifida: choort study.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2024Article
- Myelomeningocele: Long-Term Neurosurgical Management.Advances and technical standards in neurosurgery · 2024Review
- Diagnosis and Management of Tethered Cord Syndrome.Advances and technical standards in neurosurgery · 2024Article
- Fetoscopic Myelomeningocele Repair with Complete Release of the Tethered Spinal Cord Using a Three-Port Technique: Twelve-Month Follow-Up-A Case Report.Diagnostics (Basel, Switzerland) · 2022Article
- Allografts for Skin Closure during In Utero Spina Bifida Repair in a Sheep Model.Journal of clinical medicine · 2021Article
- New surgical paradigm for open neural tube defects.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2021Article
- Review
- Towards Guideline-Based Management of Tethered Cord Syndrome in Spina Bifida: A Global Health Paradigm Shift in the Era of Prenatal Surgery.Neurospine · 2019Article
- Prognosis of surgical treatment of the tethered cord syndrome in children.Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery · 2018Article
- More preoperative flexibility implies adequate neural pliability for curve correction without prophylactic untethering in scoliosis patients with asymptomatic tethered spinal cord, a retrospective study.BMC musculoskeletal disorders · 2017Article
- Reoperation in Spinal Dysraphism: Does it Help in Reversing the Neurological Deficits?Journal of neurosciences in rural practiceArticle
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionRecurrent tethered cord (RTC) is almost the rule after the repair of myelomeningocele and quite frequent after the repair of lipomyelomeningocele, resulting from the adhesions of the placode within a too narrow spinal canal. About one-third of patients with myelomeningocele and 10 % of those with spinal lipoma develop symptomatic RTC, mainly caused by the ischemic-metabolic injuries due to the cord stretching. The goal of this review is to provide information about the pathophysiology, the radiological picture, and the management of RTV according to the pertinent literature and the authors' experience. RADIOLOGICAL INVESTIGATION: The magnetic resonance imaging (MRI) picture is characterized by a low position of the conus and by tethering of the spinal cord to the subcutaneous scar or to the inner surface of the spinal canal. The radiological work-up always includes brain MRI, to rule out other possible causes of late neurological deterioration (as shunt malfunction), and MRI of the whole spinal cord, to detect possible associated lesions (syringomyelia, dermoids, etc.). X-rays and/or computed tomography scan of the spine is required for the assessment of scoliosis or other bony malformations. MANAGEMENT: The surgical treatment is planned after a multidisciplinary neurological, urological, orthopedic, physiatric, and radiological evaluation. The surgical detethering is carried out cautiously, possibly with electrophysiological intraoperative monitoring. Surgery ensures improvement or stability of the clinical picture in 70-80 % of cases, the remaining 20-30 % of patients needing multiple operations for their recovery. Complications may affect up to one-third of operated patients, being mainly represented by CSF leak, pseudomeningocele, and shunt malfunction.
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