Evidence map›Paper›PMID 38072858›Full record

SynthesisChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2024

Disparities in indications and outcomes reporting for pediatric tethered cord surgery: The need for a standardized outcome assessment tool.

Matthew C Findlay, Samuel Tenhoeve, Skyler A Terry, Rajiv R Iyer, Douglas L Brockmeyer, Michael P Kelly, John R W Kestle, David Gonda, Vijay M Ravindra

Open access · hybridAbstract readSystematic Review
In one paragraph

Synthesis in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
2.9field-weighted citation impact, top 9% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 10 citations in OpenAlex.

  1. Review
  2. Article
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors at 3 institutions in 1 country.

Matthew C FindlaySchool of Medicine, University of Utah, Salt Lake City, UT, USA.ORCID 0000-0002-7894-2941
Samuel TenhoeveSchool of Medicine, University of Utah, Salt Lake City, UT, USA.ORCID 0009-0007-9751-3724
Skyler A TerryCollege of Social and Behavioral Sciences, University of Utah, Salt Lake City, UT, USA.ORCID 0009-0007-7605-3271
Rajiv R IyerDepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA.ORCID 0000-0002-9896-6967
Douglas L BrockmeyerDepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA.ORCID 0000-0001-8602-0931
Michael P KellyDivision of Pediatric Orthopedics, Rady Children's Hospital, San Diego, CA, USA.ORCID 0000-0001-6221-7406
John R W KestleDepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA.ORCID 0000-0003-3634-2312
David GondaDivision of Pediatric Neurosurgery, Rady Children's Hospital, San Diego, CA, USA.
Vijay M RavindraDepartment of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, UT, USA. vijay.ravindra@hsc.utah.edu.ORCID 0000-0002-4496-7622
University of Utah · USRady Children's Hospital-San Diego · USNaval Medical Center San Diego · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeTethered cord syndrome (TCS) is characterized by abnormal attachment of the spinal cord neural elements to surrounding tissues. The most common symptoms include pain, motor or sensory dysfunction, and urologic deficits. Although TCS is common in children, there is a significant heterogeneity in outcomes reporting. We systematically reviewed surgical indications and postoperative outcomes to assess the need for a grading/classification system.

methodsPubMed and EMBASE searches identified pediatric TCS literature published between 1950 and 2023. Studies reporting surgical interventions, ≥ 6-month follow-up, and ≥ 5 patients were included.

resultsFifty-five studies representing 3798 patients were included. The most commonly reported non-urologic symptoms were nonspecific lower-extremity motor disturbances (36.4% of studies), lower-extremity/back pain (32.7%), nonspecific lower-extremity sensory disturbances (29.1%), gait abnormalities (29.1%), and nonspecific bowel dysfunction/fecal incontinence (25.5%). Urologic symptoms were most commonly reported as nonspecific complaints (40.0%). After detethering surgery, retethering was the most widely reported non-urologic outcome (40.0%), followed by other nonspecific findings: motor deficits (32.7%), lower-extremity/back/perianal pain (18.2%), gait/ambulation function (18.2%), sensory deficits (12.7%), and bowel deficits/fecal incontinence (12.7%). Commonly reported urologic outcomes included nonspecific bladder/urinary deficits (27.3%), bladder capacity (20.0%), bladder compliance (18.2%), urinary incontinence/enuresis/neurogenic bladder (18.2%), and nonspecific urodynamics/urodynamics score change (16.4%).

conclusionTCS surgical literature is highly variable regarding surgical indications and reporting of postsurgical outcomes. The lack of common data elements and consistent quantitative measures inhibits higher-level analysis. The development and validation of a standardized outcomes measurement tool-ideally encompassing both patient-reported outcome and objective measures-would significantly benefit future TCS research and surgical management.

Indexed as

Neural Tube DefectsOutcome Assessment, Health CareAdolescentChildChild, PreschoolHumansInfantNeurosurgical ProceduresTreatment OutcomeDetetheringPediatricsSystematic reviewTethered cord syndrome

Identifiers

PMID38072858
PMCPMC10972940
OpenAlexW4389556920

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.