Is It Possible to Correct Congenital Spinal Deformity Associated With a Tethered Cord Without Prophylactic Intradural Detethering?

Clinical Orthopaedics and Related Research
Hui-Ren TaoChunguang Duan

Abstract

Patients who have a congenital spinal deformity with a tethered cord generally are treated with prophylactic intradural detethering before deformity correction. However, the detethering procedure carries substantial risk, and it is not clear whether deformity correction can be performed without detethering. To determine the (1) correction rate, (2) proportion of patients who experienced complications after surgery, and (3) neurological status after recovery from surgery in a group of patients with congenital spinal deformity and a tethered cord who were treated either with posterior spinal fusion only (PSF), pedicle-subtraction osteotomy (PSO), or a vertebral column resection (VCR), based on an algorithmic approach. Between 2006 and 2016, we treated 50 patients surgically for a congenital spinal deformity and a tethered cord. We defined a congenital spinal deformity as one that was caused by failure of vertebral segmentation, failure of vertebral formation, or both, and we made the diagnosis of a tethered cord based on a conus medullaris lower than L2 level, or a diameter of the filum terminale greater than 2 mm, as shown on magnetic resonance image. Of those, nine patients were lost to followup before the 2-year minimum, leavi...Continue Reading

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Citations

Nov 18, 2020·European Spine Journal : Official Publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society·Kaustubh AhujaPankaj Kandwal

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