Our Summary

This research paper looks at a different approach to treating patients with a specific type of spinal deformity and a tethered spinal cord. Traditionally, these patients undergo a risky procedure to untether the spinal cord before the deformity is corrected. This study aimed to find out if the correction could be done without the detethering step.

The researchers looked at 50 patients who had this type of spinal deformity and a tethered cord. They used different surgical methods depending on the severity of the deformity and whether the patient had neurological symptoms. They examined how well the surgery corrected the deformity, whether there were any complications, and the patients’ neurological status after recovery.

The results showed that the surgeries were quite successful, with an average correction rate of 63%. Seven patients experienced major complications, but no patients in one of the surgical groups had any neurological complications after surgery. Also, patients who had neurological symptoms before surgery showed some improvement afterwards.

In conclusion, the researchers suggest that it might be possible to correct this type of spinal deformity without untethering the spinal cord first. They achieved good results and few complications in this study, but they caution that more research is needed to confirm the safety of this approach.

FAQs

  1. What is the traditional approach to treating patients with a specific type of spinal deformity and a tethered spinal cord?
  2. What were the findings of the study on correcting spinal deformity without untethering the spinal cord first?
  3. What are the potential risks and benefits of the new surgical approach proposed by the researchers?

Doctor’s Tip

One helpful tip that a doctor might tell a patient considering detethering surgery is to discuss the option of undergoing surgery to correct the spinal deformity without detethering the spinal cord first. This study suggests that this alternative approach can be successful in achieving correction of the deformity with fewer complications. However, it is important for patients to have a thorough discussion with their healthcare provider to weigh the risks and benefits of both approaches before making a decision.

Suitable For

Patients who are typically recommended detethering surgery are those who have a spinal deformity and a tethered spinal cord. These patients may experience symptoms such as back pain, leg weakness, numbness, or bowel and bladder dysfunction. In some cases, patients may also have neurological symptoms such as difficulty walking, loss of sensation, or changes in reflexes.

Detethering surgery is recommended for patients who have a tethered spinal cord, which occurs when the spinal cord is abnormally attached to surrounding tissues, causing tension and limiting its movement. This can lead to progressive neurological deficits and worsening of the spinal deformity over time.

Patients who have been diagnosed with a tethered spinal cord and are experiencing symptoms that are impacting their quality of life are typically recommended for detethering surgery. The decision to undergo surgery is based on the severity of the symptoms, the progression of the deformity, and the overall health of the patient. It is important for patients to discuss their treatment options with their healthcare provider to determine the best course of action for their specific situation.

Timeline

Before detethering surgery, a patient may experience symptoms such as back pain, leg pain, weakness, numbness, and difficulty walking. They may undergo imaging tests like MRI to diagnose the tethered spinal cord and spinal deformity. The patient would then be evaluated by a neurosurgeon and a spinal surgeon to determine the best course of treatment.

After detethering surgery, the patient will undergo a period of recovery in the hospital. They may experience pain, swelling, and limited mobility in the days following surgery. Physical therapy and rehabilitation may be necessary to regain strength and function. Follow-up appointments with the surgical team will be scheduled to monitor the patient’s progress and address any concerns.

Overall, the goal of detethering surgery is to relieve symptoms, improve function, and prevent further complications related to the tethered spinal cord and spinal deformity. With proper care and rehabilitation, patients can expect to see improvements in their quality of life and long-term outcomes.

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 in my case and why is it considered necessary?
  2. What are the risks and potential complications associated with detethering surgery?
  3. Are there any alternative treatment options to detethering surgery that I should consider?
  4. How will detethering surgery affect my overall recovery and rehabilitation process?
  5. What is the success rate of detethering surgery in correcting my specific spinal deformity and tethered cord condition?
  6. How experienced is the surgical team in performing detethering surgery, and what is their track record with similar cases?
  7. What is the expected outcome in terms of pain relief, mobility improvement, and overall quality of life after detethering surgery?
  8. Will I need any additional treatments or follow-up care after detethering surgery?
  9. Are there any long-term implications or risks associated with detethering surgery that I should be aware of?
  10. Can you provide me with any resources or information to help me better understand detethering surgery and make an informed decision about my treatment plan?

Reference

Authors: Tao H, Yang K, Li T, Yang W, Feng C, Li H, Su W, Duan C. Journal: Clin Orthop Relat Res. 2019 Jul;477(7):1689-1697. doi: 10.1097/CORR.0000000000000652. PMID: 30801282