Our Summary

This study looked at children born with early onset scoliosis (a condition causing the spine to curve) who also have tethered spinal cord syndrome (a nerve issue that often occurs alongside scoliosis). The researchers wanted to see if there were any issues during or after surgery in those who had both conditions, compared to those who only had scoliosis. They also wanted to see if a procedure called “detethering” (which involves freeing up the spinal cord) had any effect on the outcome of the surgery.

After looking at data from 477 patients, they found that there were no significant differences in the age of patients at their first MRI, the severity of their spinal curve, or the number of complications during or after surgery between those who had both conditions and those who only had scoliosis. However, among those with both conditions, those who underwent detethering experienced fewer complications after surgery, and less hardware failure and infection.

However, the researchers warn that these results should be taken with caution, as those who did not undergo detethering were more likely to have had a different kind of surgery that encourages growth of the spine. Nonetheless, this study suggests that detethering could potentially improve surgical outcomes for children with early onset scoliosis and tethered spinal cord syndrome.

FAQs

  1. What is the purpose of the detethering procedure in patients with early onset scoliosis and tethered spinal cord syndrome?
  2. What were the main findings of the study regarding the outcomes of the surgery in patients with both conditions versus those with only scoliosis?
  3. Are there any potential risks or precautions to consider with the detethering procedure according to the study?

Doctor’s Tip

One helpful tip a doctor might give a patient about detethering surgery is to discuss the potential benefits and risks with their healthcare team. It is important for the patient to have a clear understanding of what the surgery entails, what to expect during recovery, and any potential complications that may arise. Additionally, following post-operative care instructions and attending all follow-up appointments is crucial for a successful outcome.

Suitable For

Patients who are typically recommended detethering surgery are those who have tethered spinal cord syndrome, which can occur alongside conditions such as scoliosis. This surgery may be recommended to improve outcomes and reduce complications associated with spinal surgery in these patients.

Timeline

Before detethering surgery:

  • Patient is diagnosed with early onset scoliosis and tethered spinal cord syndrome
  • Patient may experience symptoms such as back pain, leg weakness, numbness, and bowel or bladder issues
  • Patient undergoes imaging tests such as MRI to confirm diagnosis
  • Treatment options such as bracing or spinal fusion may be considered
  • Decision is made to proceed with detethering surgery to free up the spinal cord

After detethering surgery:

  • Patient undergoes detethering surgery to free up the spinal cord
  • Patient may experience some pain and discomfort after surgery
  • Patient is monitored closely for complications such as hardware failure or infection
  • Patient may require physical therapy to regain strength and mobility
  • Patient experiences improvement in symptoms such as back pain, leg weakness, and numbness
  • Follow-up imaging tests are done to assess the success of the surgery and monitor for any recurrence of tethering
  • Overall, patient experiences improved surgical outcomes compared to those who did not undergo detethering surgery

What to Ask Your Doctor

  1. What is detethering surgery and how does it differ from traditional spinal surgery?
  2. Are there any specific risks or complications associated with detethering surgery?
  3. How will detethering surgery impact my child’s recovery process?
  4. What can we expect in terms of long-term outcomes following detethering surgery?
  5. Are there any alternative treatment options to consider before moving forward with detethering surgery?
  6. How experienced is the surgical team in performing detethering procedures?
  7. Will my child need physical therapy or other post-operative care following detethering surgery?
  8. Are there any specific lifestyle changes or precautions my child should take after detethering surgery?
  9. How will detethering surgery impact my child’s overall quality of life?
  10. Are there any specific follow-up appointments or tests that will be necessary after detethering surgery?

Reference

Authors: Muñoz AM, Alvandi LM, Gjonbalaj E, Morris A, Sponseller P, Anderson RCE, Gomez JA; Pediatric Spine Study Group. Journal: J Pediatr Orthop. 2025 Apr 1;45(4):e352-e357. doi: 10.1097/BPO.0000000000002883. Epub 2024 Dec 24. PMID: 39716830