Our Summary

This research paper looks at the outcomes of treating patients with congenital scoliosis (a curvature of the spine present at birth) and tethered cord syndrome (a condition where the spinal cord is attached to the spine, limiting its movement) with a surgery to correct the spinal deformity. The researchers compared patients who had undergone a separate surgery to untether the spinal cord before the deformity correction (the NI group) with those who did not have this separate surgery (the NNI group). They found that there was no significant difference in the success of the deformity correction, the length of the surgery, the amount of blood lost, or the rate of complications between the two groups. However, when they only looked at the most reliable studies, they found that the NNI group had shorter surgery times and less blood loss. This suggests that the separate surgery to untether the spinal cord may not be necessary before correcting the spinal deformity.

FAQs

  1. What is the main difference between the NI group and the NNI group in this study?
  2. What were the main findings of this research paper on detethering surgery in patients with congenital scoliosis and tethered cord syndrome?
  3. Does the study suggest that untethering the spinal cord is unnecessary before correcting the spinal deformity?

Doctor’s Tip

A doctor might tell a patient undergoing detethering surgery that additional surgery to untether the spinal cord may not be necessary before correcting the spinal deformity. This can help reduce the length of the surgery, amount of blood lost, and risk of complications. It is important to discuss this option with your doctor to determine the best course of action for your specific situation.

Suitable For

Patients who are typically recommended detethering surgery are those who have been diagnosed with tethered cord syndrome, which can cause symptoms such as back pain, leg weakness, bladder dysfunction, and scoliosis. Patients with congenital scoliosis who also have tethered cord syndrome may benefit from detethering surgery to alleviate symptoms and prevent further complications. It is important for patients to undergo a thorough evaluation by a medical team, including a neurosurgeon and orthopedic surgeon, to determine if detethering surgery is the best course of action for their specific condition.

Timeline

Before detethering surgery:

  • Patient may experience symptoms such as back pain, leg weakness, numbness, and bladder or bowel dysfunction due to tethered cord syndrome
  • Patient undergoes diagnostic tests such as MRI and neurological exams to confirm the diagnosis
  • Treatment may involve physical therapy, pain management, and monitoring of symptoms
  • Surgery may be recommended if symptoms worsen or if there is a risk of permanent neurological damage

After detethering surgery:

  • Patient undergoes pre-operative evaluations and tests to assess their overall health and readiness for surgery
  • Surgery is performed to release the tethered spinal cord and correct any spinal deformities
  • Patient may experience pain and discomfort post-operatively, which is managed with pain medication
  • Physical therapy and rehabilitation are initiated to help the patient regain strength and mobility
  • Follow-up appointments are scheduled to monitor the patient’s progress and address any complications or concerns

What to Ask Your Doctor

  1. What is the purpose of detethering surgery in relation to my condition?
  2. What are the potential risks and complications associated with detethering surgery?
  3. How will detethering surgery affect my current symptoms and quality of life?
  4. What is the success rate of detethering surgery in patients with my specific condition?
  5. How long is the recovery period after detethering surgery and what can I expect during this time?
  6. Will I need any additional treatments or therapies following detethering surgery?
  7. Are there any alternative treatment options to detethering surgery that I should consider?
  8. How experienced are you in performing detethering surgery and what is your success rate?
  9. Are there any specific pre-operative or post-operative instructions I should follow to optimize the outcome of detethering surgery?
  10. How will detethering surgery impact my long-term prognosis and potential for future complications?

Reference

Authors: Ahuja K, Ifthekar S, Mittal S, Yadav G, Sudhakar PV, Barik S, Kandwal P. Journal: Eur Spine J. 2021 Mar;30(3):599-611. doi: 10.1007/s00586-020-06662-7. Epub 2020 Nov 17. PMID: 33201289