ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2018
Prognosis of surgical treatment of the tethered cord syndrome in children.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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3 citing papers in PubMed.
- Clinical analysis of tethered cord syndrome and gene expression profiling of wound healing surgery.Postepy dermatologii i alergologii · 2023Article
- Article
- Microsurgical efficacy in 326 children with tethered cord syndrome: a retrospective analysis.Neural regeneration research · 2019Article
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Authors and funding
4 authors.
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Abstract
purposeThe aim of this study was to identify the factors relevant to the prognosis of the outcome of the surgical treatment of the tethered cord syndrome (TCS).
methodsThe results of surgical treatment performed on 58 children with TCS were analyzed, with follow-up periods ranging from 6 months to 5 years. The data of preoperative clinical and instrumental examinations, as well as those of intraoperative electrophysiological diagnostics and morphometry, were compared with the dynamics of the TCS clinical presentation.
resultsThe recovery rate was significantly higher in children with filum terminale abnormality (p = 0.014), as well as grade I tethering (p = 0.0037), and when the spinal cord tracts at the level of intervention were intact (p = 0.018). Complete untethering (p = 0.04) and a low threshold value of amperage in direct stimulation (< 1 mA) (p = 0.016) were identified as factors for a favorable outcome. Worsening of neurological symptoms was more frequent in children operated over the age of 10 (p = 0.03), when the TCS was manifested exclusively through the pelvic dysfunction (p = 0.00004), if the F-wave block is less than 30% (p = 0.0045) and the stimulation threshold during root mapping ranged from 1 to 5 mA (p = 0.01).
conclusionThe operation is recommended when structural changes are minimal. In case of severe structural changes, if the spinal cord tracts are intact, the indications for operation are determined by the risk of irreversible structural changes due to the natural course of the disease, although the risks are substantially higher.
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