ArticleChild's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery2025
Association between orthopedic manifestations and tethered cord release in patients with spina bifida: a survival analysis.
Article in Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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.
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.
Who cites it
1 citing paper in PubMed.
- Complications and outcomes of spinal deformity correction in patient with open neural tube defects.Spine deformity · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposePatients with spina bifida (SB) are at risk for symptomatic tethered cord syndrome (TCS). Orthopedic decline, a common manifestation of TCS, is an indication for tethered cord release (TCR). Our objective is to determine if patients with SB who have undergone specific orthopedic operations (release of hip or knee contracture and correction of cavus foot) require TCR at a higher rate than those not undergoing these operations.
methodsAn institutional database was queried to identify all children with SB from 2009 to 2022. Data included functional level of lesion (FLOL), ambulatory status, and diagnosis of myelomeningocele (MMC) vs. closed neural tube defects. Survival analysis was performed to test the association between TCR and index orthopedic operations. Kaplan-Meier survival curves and multivariate Cox proportional hazard models were generated.
resultsThere were 659 patients. Thirty-four (5.2%) had a history of orthopedic operation, and 625 (94.8%) had no history of orthopedic operation either before TCR or at last follow-up. Three of thirty-four (8.6%) in the orthopedic group underwent TCR after the orthopedic operation. Two hundred two of six hundred twenty-five (32.3%) in the non-orthopedic group underwent TCR. The adjusted hazard ratio (controlling for FLOL, ambulation, and diagnosis) was 3.8 (95% confidence interval 1.2-11). In MMC, the hazard ratio for the non-orthopedic group compared to the orthopedic group was 5.05 (95% confidence interval 1.2-20.7) which was significant.
conclusionPatients with MMC who underwent the specific orthopedic operations were significantly less likely to have subsequent TCR surgery. One possible explanation is that lower extremity deformity correction may alter surgeon behavior regarding TCR.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.