Our Summary

This research paper is about a surgical procedure performed on six patients who had a condition called myelocystocele, which is a type of spina bifida. This condition causes a large lump to appear on the lower back, which is covered by healthy skin and can move on its own. The patients, aged from 1-4.5 years, underwent surgery between 2015 and 2020. Two of the patients also had a condition called VACTERL syndrome.

The surgery involved closing up the soft tissues, removing the sacs that had formed due to the condition, and untethering the spinal cord. No patients had complications after the surgery, such as leaks of cerebrospinal fluid or infection. However, two patients (33.3%) experienced a loss of muscle function.

The paper suggests that it is best to diagnose this condition before birth and have surgery early on to prevent a decline in neurological function. It also mentions that VACTERL syndrome is a common condition and should be looked for.

FAQs

  1. What is the surgical procedure described in the research paper for treating myelocystocele?
  2. Were there any complications reported after the surgery?
  3. Why does the paper suggest diagnosing the condition before birth and having surgery early on?

Doctor’s Tip

A doctor might tell a patient undergoing detethering surgery to make sure to follow post-operative instructions carefully, including avoiding strenuous activity and keeping the surgical site clean and dry. They may also recommend physical therapy to help regain any lost muscle function and to promote overall recovery. It is important for patients to communicate any concerns or changes in symptoms to their healthcare provider to ensure the best possible outcome.

Suitable For

Patients who are typically recommended detethering surgery include those with conditions such as myelocystocele, spina bifida, and VACTERL syndrome. These conditions can cause tethering of the spinal cord, leading to neurological symptoms and potential complications. Surgery is often recommended to untether the spinal cord and prevent further decline in neurological function. Early diagnosis and intervention are crucial in these cases to achieve the best outcomes for patients.

Timeline

Before detethering surgery:

  • Patient is diagnosed with myelocystocele, a type of spina bifida, typically during pregnancy or shortly after birth
  • Patient may experience symptoms such as a lump on the lower back, mobility issues, and potential neurological deficits
  • Patient undergoes diagnostic tests such as MRI to confirm the diagnosis and assess the severity of the condition
  • Patient may undergo conservative management such as physical therapy and medication to manage symptoms and prevent further complications

After detethering surgery:

  • Patient undergoes surgery to close up soft tissues, remove sacs formed due to the condition, and untether the spinal cord
  • Patient is monitored closely for any complications such as leaks of cerebrospinal fluid or infection
  • Patient may experience temporary loss of muscle function post-surgery
  • Patient undergoes rehabilitation and physical therapy to regain strength and mobility
  • Patient is followed up with regular check-ups and monitoring to ensure the success of the surgery and to address any potential long-term complications.

What to Ask Your Doctor

Some questions a patient should ask their doctor about detethering surgery include:

  1. What is the purpose of detethering surgery for my condition?
  2. What are the potential risks and complications associated with detethering surgery?
  3. How long is the recovery process after detethering surgery?
  4. Will I need any additional treatments or therapies following detethering surgery?
  5. How likely is it that my neurological function will improve after detethering surgery?
  6. Are there any long-term effects or implications of detethering surgery that I should be aware of?
  7. What is the success rate of detethering surgery for patients with myelocystocele and/or VACTERL syndrome?
  8. Are there any alternative treatment options to consider before proceeding with detethering surgery?
  9. What is the experience and expertise of the surgical team performing the detethering surgery?
  10. Are there any specific pre-operative or post-operative instructions I should follow to ensure the best possible outcome from detethering surgery?

Reference

Authors: Massa DS, Montivero NA, Medina SAP. Journal: Surg Neurol Int. 2022 Jun 3;13:234. doi: 10.25259/SNI_299_2022. eCollection 2022. PMID: 35855164