Our Summary

This study looked at children with early onset scoliosis (EOS) and tethered spinal cord (TSC), a condition where the spinal cord is attached at the base, causing it to stretch and potentially causing damage. In these cases, doctors often perform a detethering procedure to free the spinal cord, followed by a spinal deformity correction (SDC) to straighten the spine. The researchers wanted to see if the age of the child or the severity of the curve in their spine at the time of detethering had any effect on how the curve progressed over the next two years.

They found that children who were younger when they had the detethering procedure were less likely to see their spine curve get worse. However, the severity of the curve before the procedure didn’t seem to affect how the curve progressed. This suggests that doing the detethering procedure earlier might help slow down the progression of the scoliosis. But this is a preliminary finding and needs to be confirmed with more research on more patients.

FAQs

  1. What is a detethering procedure and why is it performed on children with tethered spinal cord (TSC)?
  2. Did the study find any correlation between the age of the child at the time of detethering and the progression of the spinal curve?
  3. Does the severity of the spinal curve prior to the detethering procedure impact the progression of the curve according to this study?

Doctor’s Tip

A helpful tip a doctor might tell a patient about detethering surgery is to follow post-operative care instructions carefully to ensure proper healing and recovery. This may include avoiding strenuous activities, maintaining good posture, attending physical therapy sessions, and attending follow-up appointments with your healthcare provider. It’s important to communicate any concerns or changes in symptoms to your doctor to address them promptly.

Suitable For

Typically, detethering surgery is recommended for patients, commonly children, who have conditions such as early onset scoliosis (EOS) and tethered spinal cord (TSC). These conditions often result in the spinal cord being attached at the base, causing it to stretch and potentially inflict damage. The surgery can help to prevent the progression of the scoliosis especially when done at an early age.

Timeline

Before detethering surgery:

  • Patient experiences symptoms such as back pain, leg weakness, and bladder/bowel dysfunction
  • Patient undergoes imaging tests such as MRI to diagnose tethered spinal cord
  • Patient may undergo physical therapy or other non-surgical treatments to manage symptoms
  • Surgeon evaluates patient’s condition and decides on detethering surgery

After detethering surgery:

  • Patient undergoes detethering procedure to free the spinal cord
  • Patient may also undergo spinal deformity correction to straighten the spine
  • Recovery period where patient may experience pain, limited mobility, and need for physical therapy
  • Follow-up appointments to monitor spinal curvature and overall spinal health
  • Patient may experience improvements in symptoms such as decreased pain and improved mobility
  • Long-term monitoring to ensure that spinal curvature does not worsen and that symptoms do not return

What to Ask Your Doctor

  1. What is the purpose of detethering surgery in my case?
  2. How will detethering surgery benefit me in the long term?
  3. What are the potential risks and complications associated with detethering surgery?
  4. What is the expected recovery time and rehabilitation process after detethering surgery?
  5. How will detethering surgery impact my spinal deformity and scoliosis?
  6. Are there any alternative treatment options to consider before proceeding with detethering surgery?
  7. How many detethering surgeries have you performed for patients with similar conditions?
  8. What is the success rate of detethering surgery in improving spinal cord function and spinal deformity?
  9. What follow-up care will be needed after detethering surgery?
  10. Are there any lifestyle modifications or restrictions I should be aware of after detethering surgery?

Reference

Authors: Iyer RR, Fano AN, Matsumoto H, Sinha R, Roye BD, Vitale MG, Anderson RCE; Pediatric Spine Foundation. Journal: Spine Deform. 2023 May;11(3):739-745. doi: 10.1007/s43390-022-00612-7. Epub 2022 Dec 14. PMID: 36517658