Our Summary
This research paper discusses a study conducted over 20 years at a single institution, focusing on surgeries performed on children under 19 years old to correct a condition called fibrofatty filum terminale (FFT). This condition can cause a range of symptoms including skin changes and lower limb neurological deficits.
The study aimed to evaluate the results of these surgeries, looking at complications and long-term outcomes. In particular, the researchers were interested in assessing factors that might lead to the need for patients to use a catheter to help them urinate after the surgery.
A total of 164 surgeries were performed from 2000 to 2020. The researchers found that the surgery could be performed safely as a preventive measure, as well as a therapeutic one. However, they noted that patients who had abnormal pre-surgery tests relating to their urinary system, and those with an associated condition called an intraspinal syrinx, were more likely to need a catheter after surgery.
The researchers concluded that these risks should be clearly communicated to patients and their caregivers during the pre-surgery counseling process. They also noted that their study could help inform future research and decision-making in the treatment of FFT.
FAQs
- What is the main focus of this 20-year study on detethering surgeries?
- What factors were found to increase the likelihood of a patient needing a cathary after surgery?
- What recommendations did the researchers make based on their findings about pre-surgery communication and counseling for patients with FFT?
Doctor’s Tip
A helpful tip a doctor might give a patient considering detethering surgery for fibrofatty filum terminale (FFT) is to discuss any abnormal pre-surgery tests related to the urinary system and the presence of an intraspinal syrinx. Understanding these factors can help manage expectations and potential outcomes, including the need for a catheter post-surgery. Open communication with your healthcare team is key to ensuring the best possible outcome.
Suitable For
Patients who are typically recommended detethering surgery are those who have fibrofatty filum terminale (FFT) causing symptoms such as skin changes and lower limb neurological deficits. In particular, patients with abnormal pre-surgery tests related to their urinary system and those with an intraspinal syrinx may be at higher risk for needing a catheter after surgery. Detethering surgery can be performed as a preventive or therapeutic measure to improve symptoms and long-term outcomes for patients with FFT. It is important for healthcare providers to communicate the risks and benefits of the surgery to patients and their caregivers during the pre-surgery counseling process.
Timeline
Before detethering surgery, a patient may experience symptoms such as skin changes and lower limb neurological deficits. They may undergo pre-surgery tests to assess their condition and determine the need for surgery.
During detethering surgery, the fibrofatty filum terminale is corrected to alleviate symptoms and prevent further complications. The surgery is performed under general anesthesia, and the patient may stay in the hospital for a few days for monitoring and recovery.
After detethering surgery, the patient may experience some pain and discomfort at the surgical site. They will be prescribed pain medication to manage any discomfort. Physical therapy may be recommended to help the patient regain strength and mobility.
In the long term, the patient may experience improvements in their symptoms and overall quality of life. However, some patients may need to use a catheter to help them urinate after surgery, especially if they had abnormal pre-surgery tests or an associated condition like an intraspinal syrinx. Patients should be informed of these potential risks during pre-surgery counseling. Follow-up appointments will be scheduled to monitor the patient’s progress and address any concerns.
What to Ask Your Doctor
Some questions a patient should ask their doctor about detethering surgery for fibrofatty filum terminale (FFT) may include:
- What are the potential risks and complications associated with detethering surgery for FFT?
- How long is the recovery process after detethering surgery, and what can I expect during this time?
- Will I need to use a catheter after the surgery, and if so, for how long?
- What factors might increase the likelihood of needing a catheter after surgery, and do I have any of these risk factors?
- How successful is detethering surgery in improving symptoms associated with FFT, such as skin changes and lower limb neurological deficits?
- Are there any alternative treatments or therapies for FFT that I should consider before opting for surgery?
- How many detethering surgeries have you performed for FFT, and what is your success rate?
- What is the long-term outlook for patients who undergo detethering surgery for FFT?
- How will my quality of life be impacted after detethering surgery, and what support or resources are available to help me during the recovery process?
- Are there any specific lifestyle changes or precautions I should take after detethering surgery to optimize the outcome and prevent complications?
Reference
Authors: Lim JX, Fong E, Goh C, Ng LP, Merchant K, Low DCY, Seow WT, Low SYY. Journal: J Neurosurg Pediatr. 2022 Dec 2;31(3):197-205. doi: 10.3171/2022.8.PEDS22103. Print 2023 Mar 1. PMID: 36461829