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A critical analysis of surgery for occult tethered cord syndrome.
Michael, Marissa M; Garton, Andrew L A; Kuzan-Fischer, Claudia M; Uribe-Cardenas, Rafael; Greenfield, Jeffrey P.
Afiliação
  • Michael MM; Department of Neurosurgery, Weill Cornell Medical Center, New York-Presbyterian Hospital, New York City, NY, USA.
  • Garton ALA; Department of Neurosurgery, Weill Cornell Medical Center, New York-Presbyterian Hospital, New York City, NY, USA. garton.ala@gmail.com.
  • Kuzan-Fischer CM; Department of Neurosurgery, University Children's Hospital Zurich, Zurich, Switzerland.
  • Uribe-Cardenas R; Department of Neurosurgery, Weill Cornell Medical Center, New York-Presbyterian Hospital, New York City, NY, USA.
  • Greenfield JP; Department of Neurosurgery, Weill Cornell Medical Center, New York-Presbyterian Hospital, New York City, NY, USA. jpgreenf@med.cornell.edu.
Childs Nerv Syst ; 37(10): 3003-3011, 2021 10.
Article em En | MEDLINE | ID: mdl-34268593
ABSTRACT

INTRODUCTION:

Tethered cord syndrome (TCS) is an amalgamation of neurological, urological, orthopedic, and dermatologic signs and symptoms with radiographic evidence of a thickened filum and low-lying conus. Surgical sectioning of the filum and disconnection of any tethering entities such as dermal sinus tracts or lipomas has been shown to improve outcomes. The manifestation of TCS symptoms in the absence of a low-lying conus has been referred to as occult tethered cord syndrome (OTCS) and is much less well reviewed in the literature. To date, there has only been one randomized controlled trial examining the effect of intervention in OTCS; therefore, contemporary data is often elicited from limited cohorts.

OBJECTIVE:

To perform a comprehensive literature review of management in OTCS and evaluate treatment response rates to sectioning of the filum terminale.

RESULTS:

Seventeen papers met inclusion criteria for our review. Sample sizes ranged from 8 to 60 children, and results were mixed, often dependent on study design, definition of typical OTCS symptoms, and follow-up intervals. Symptomatic improvement was observed in > 50% of patients for all but one study; however, the recurrence rates were highly variable.

CONCLUSION:

The data regarding the efficacy of surgical treatment in OTCS is mixed and merits more rigorous scientific examination with strict and clear parameters regarding symptomatic operationalization and follow-up time points to monitor for TCS recurrence.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cauda Equina / Lipoma / Defeitos do Tubo Neural Idioma: En Ano de publicação: 2021 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Cauda Equina / Lipoma / Defeitos do Tubo Neural Idioma: En Ano de publicação: 2021 Tipo de documento: Article