SynthesisFrontiers in surgery2025
Vertebral column resection and homogeneous spinal-shortening axial decompression for tethered cord syndrome: a meta-analysis and meta regression.
Synthesis in Frontiers in surgery, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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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.
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5 authors.
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Abstract
Introduction: Tethered cord syndrome (TCS) is a group of neurological symptoms due to increased tension along the spinal cord. Surgical untethering has been the conventional treatment to relieve the spinal cord tension. However, untethering is associated with retethering of the spinal cord and the concerns regarding intradural nerve components manipulation. Recently, spinal column shortening (SCS) is emerging as an alternative treatment. This study aims to compare the efficacy of vertebral column resection (VCR) and homogeneous spinal-shortening axial decompression (HSAD) in improving neurological outcomes in TCS and the associated complications. Methods: A PROSPERO-registered systematic search was conducted in the ScienceDirect, PubMed, Embase, and Cochrane databases to identify longitudinal studies up to August 2024 (CRD42024566861). SCS techniques assessed includes VCR and HSAD. Data were extracted on patient demographics, clinical improvements, and complication rates. Single-arm outcomes were pooled using a random-effects GLMM with a logit link. Heterogeneity was assessed and potential moderators were examined through meta-regression. Freeman-Tukey method was used for sensitivity analyses. Publication bias was assessed using Egger's regression test and trim-and-fill analysis. All analyses were conducted with STATA software ( Results: The meta-analysis included 15 studies comprising 251 participants (44.2% male; mean age 28.37 ± 5.7 years), with mean operation time of 309.98 ± 53.35 min, estimated blood loss of 1,074.36 ± 338.51 mL, and follow-up duration of 36.95 ± 6.83 months. HSAD had shorter operation time ( Conclusions: VCR and HSAD both offer significant neurological improvements and satisfactory patient outcomes with no comparable significant complications. HSAD has the greater potential to improve bladder function in TCS. Patient treatment selection should be individualized depending on the presence of comorbidity and surgeon's experience. Systematic Review Registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD42024566861, identifier CRD42024566861.
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