Spine-shortening osteotomy for patients with tethered cord syndrome: a systematic review and meta-analysis

2018 ◽  
Vol 40 (5) ◽  
pp. 340-363 ◽  
Author(s):  
Weiwei Lin ◽  
Hongtao Xu ◽  
Guman Duan ◽  
Jinjin Xie ◽  
Yisheng Chen ◽  
...  
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Shortening Osteotomy

Surgical Treatment of Tethered Cord Syndrome in Adults: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 137 ◽  
pp. e221-e241 ◽  
Author(s):  
Kyle P. O'Connor ◽  
Adam D. Smitherman ◽  
Camille K. Milton ◽  
Ali H. Palejwala ◽  
Victor M. Lu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Surgical Treatment ◽  
Meta Analysis ◽  
Tethered Cord ◽  
Tethered Cord Syndrome

scholarly journals Incidence of intraspinal abnormalities in congenital scoliosis: a systematic review and meta-analysis

2020 ◽  
Vol 15 (1) ◽  
Author(s):  
Xudong Wang ◽  
Yangke Yu ◽  
Ningning Yang ◽  
Lei Xia
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Tethered Cord ◽  
Congenital Scoliosis ◽  
Cochrane Library ◽  
Resonance Imaging ◽  
R Software ◽  
Dural Ectasia ◽  
Magnetic Resonance Imaging Mri

Abstract Objective This is the first systematic review and meta-analysis on the overall incidence of intraspinal abnormalities in patients with congenital scoliosis (CS) and potential influencing factors. Methods We searched three large electronic databases (PubMed, EMBASE, and Cochrane Library) for potentially relevant studies. The quality of the included studies was assessed independently by two authors using the Methodological Index for Non-Randomized Studies (MINORS) criteria. Data on the number of CS patients, number of CS patients with intraspinal abnormalities, sex of the patients, and CS types were extracted from the included studies. R software was used to pool and analyze all the extracted data. Results This meta-analysis included 10 articles, and 671 of 1863 CS patients undergoing magnetic resonance imaging (MRI) examinations were identified to have intraspinal abnormalities. The overall incidence of intraspinal abnormalities in the patients with CS was 37% (95% CI, 29–45%). Diastematomyelia was the most common intraspinal abnormality and was detected in 45.60% of the patients with intraspinal abnormalities (306/671). The remaining intraspinal abnormalities included syringomyelia (273/671, 40.69%), tethered cord (190/671, 28.32%), low conus (58/671, 8.64%), intraspinal mass (39/671, 5.81%), Chiari malformation (32/671, 4.77%), fatty filum (27/671, 4.02%), spina bifida (occulta excluded) (17/671, 2.53%), tumor (17/671, 2.53%), cyst (12/671, 1.79%), syringomyelus (4/671, 0.60%), dural ectasia (1/671, 0.15%), and undiagnosed cord MRI hyperintensity (1/671, 0.15%). The patient’s sex and CS type were not factors that affected the incidence of intraspinal abnormalities in CS patients (all P > 0.05). Conclusions This meta-analysis revealed that the overall incidence of intraspinal abnormalities detected by MRI in CS patients was 37%. Diastematomyelia was the most common intraspinal abnormality. The patient’s sex and CS type were not factors that affected the incidence of intraspinal abnormalities in CS patients.

Spine-shortening osteotomy for patients with tethered cord syndrome caused by lipomyelomeningocele

2011 ◽  
Vol 15 (1) ◽  
pp. 21-27 ◽  
Author(s):  
Shoichi Kokubun ◽  
Hiroshi Ozawa ◽  
Toshimi Aizawa ◽  
Ngo Minh Ly ◽  
Yasuhisa Tanaka
Keyword(s):  
Spinal Cord ◽  
Japanese Orthopaedic Association ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Neurological Deficits ◽  
Thoracic Myelopathy ◽  
Shortening Osteotomy ◽  
Cord Injury ◽  
Rod System

Object Tethered cord syndrome (TCS) is a disorder involving an abnormal stretching of the tethered spinal cord caused by several pathological conditions and presents with a variety of neurological symptoms. Untethering (tethered cord release) is the gold standard treatment for TCS. However, untethering carries risks of spinal cord injury and postoperative retethering. To avoid these potential risks, the authors applied spine-shortening osteotomy to adult patients with TCS, and report on the surgical procedure and treatment outcomes. Methods Eight patients with TCS caused by a lipomyelomeningocele were surgically treated by the authors' original procedure of spine-shortening osteotomy. Six patients were male and 2 were females; average age at the time of surgery was 31 years old. Spine-shortening osteotomy was performed at the level of L-1 in all but 2 patients, in whom it was performed at T-12, with spinal fusion between T-12 and L-2 or T-11 and L-1 using a pedicle screw–rod system. The average follow-up period was 6.2 years and the patients' pre- and postoperative conditions were evaluated clinically and radiologically. Results Preoperatively, all patients displayed severe neurological deficits such as motor disturbance, muscle atrophy, and bladder dysfunction. Several months before surgery, all showed progressive symptoms. Those symptoms showed initial improvement in 6 patients and stabilized in 2 postoperatively, but the improved symptoms worsened again in 4 of the 6 patients. The osteotomized vertebrae were shortened by 21 mm on average, and all spines showed complete bone union without loss of correction. At the final follow-up evaluations, 6 patients showed stabilization as per the modified Japanese Orthopaedic Association score for thoracic myelopathy. Conclusions Spine-shortening osteotomy successfully helps reduce the spinal cord tension without causing direct neural damage. At minimum, it stabilized the patients' symptoms and/or helped delay neurological deterioration for a period of time. Spine-shortening osteotomy might be a feasible mode of treatment for adult TCS caused by a spinal lipoma.

Multisegmental Spinal-Shortening Osteotomy for the Treatment of Tethered Cord Syndrome: A Retrospective Study of Six Consecutive Cases

2014 ◽  
Vol 4 (1_suppl) ◽  
pp. s-0034-1376546-s-0034-1376546
Author(s):  
J. Shi ◽  
Lianshun Jia ◽  
Wen Yuan ◽  
Bin Ni ◽  
Xiaojian Ye ◽  
...  
Keyword(s):  
Retrospective Study ◽  
Tethered Cord ◽  
Tethered Cord Syndrome ◽  
Shortening Osteotomy
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