Our Summary

This research paper is about the use of a device called an exoscope in spinal surgeries for children. The exoscope is like a microscope that provides a better view of the surgical area and is more comfortable for the surgeon to use. The study looked back at spinal surgeries performed on children under 18 years old from 2020 to 2023 in one hospital, by three experienced surgeons.

The study found that 96 surgeries were done on 89 children, with boys making up about 43% of the patients. The average age of the patients was 12 years old. The most common surgery was detethering the spinal cord, which is a procedure to free the spinal cord when it is attached to the spine. The average time for all the surgeries was about 155 minutes, and the average blood loss was 18 milliliters. The average hospital stay was about 5.4 days.

About 15% of the patients had complications, but at the final check-up, more than 83% of the patients who had symptoms before the surgery reported that their symptoms had improved.

The conclusion of the paper is that the exoscope is a good tool for these types of surgeries in children. It has acceptable surgery times, blood loss, length of hospital stay, and rate of symptom improvement.

FAQs

  1. What is an exoscope and how is it used in spinal surgeries for children?
  2. What is detethering surgery and why is it commonly performed on children?
  3. What were the key findings of the research study regarding the use of exoscope in spinal surgeries for children?

Doctor’s Tip

A helpful tip a doctor might tell a patient about detethering surgery is to follow post-operative care instructions closely, including taking prescribed medications, attending follow-up appointments, and avoiding strenuous activities. It is also important to report any new or worsening symptoms to your healthcare provider promptly. Additionally, participating in physical therapy as recommended can help with recovery and improve outcomes.

Suitable For

Patients who are typically recommended detethering surgery are those who have symptoms related to a tethered spinal cord, such as back pain, leg weakness, bladder or bowel dysfunction, scoliosis, or foot deformities. These symptoms may be caused by the spinal cord being stretched or compressed due to the attachment to the spine. Patients may also be recommended for detethering surgery if they have a history of a spinal cord injury, spinal cord tumor, or spinal cord malformation that is causing symptoms. It is important for patients to be evaluated by a neurosurgeon or orthopedic surgeon who specializes in spinal cord surgery to determine if detethering surgery is the best treatment option for their condition.

Timeline

Before detethering surgery:

  • Patient may experience symptoms such as back pain, leg weakness, bladder or bowel dysfunction, and numbness or tingling in the legs
  • Patient undergoes diagnostic tests such as MRI or CT scan to confirm the presence of tethered spinal cord
  • Patient consults with a neurosurgeon to discuss the risks and benefits of detethering surgery
  • Surgery is scheduled and patient undergoes pre-operative preparation such as fasting and medication adjustments

After detethering surgery:

  • Patient is monitored closely in the recovery room for any immediate complications
  • Patient may spend a few days in the hospital for post-operative care and monitoring
  • Patient may experience some pain and discomfort at the incision site
  • Patient gradually resumes normal activities under the guidance of healthcare providers
  • Patient attends follow-up appointments to monitor recovery progress and address any concerns
  • Patient may experience improvement in symptoms such as reduced pain, improved mobility, and better bladder or bowel function

Overall, detethering surgery can lead to significant improvement in symptoms and quality of life for patients with a tethered spinal cord.

What to Ask Your Doctor

  1. What is detethering surgery and why is it necessary for my condition?
  2. How experienced are you in performing detethering surgeries on children?
  3. What are the potential risks and complications associated with detethering surgery?
  4. How long will the surgery take and what is the expected recovery time?
  5. Will I need physical therapy or rehabilitation after the surgery?
  6. How will the exoscope improve the outcome of my surgery compared to traditional methods?
  7. What is the success rate of detethering surgery in children at this hospital?
  8. Are there any long-term effects or considerations I should be aware of after the surgery?
  9. Will I need any additional follow-up appointments or tests after the surgery?
  10. Are there any alternative treatment options to consider before proceeding with detethering surgery?

Reference

Authors: Cunningham CM, Nawabi N, Saway BF, Sowlat MM, Pereira MP, Hubbard ZS, Lajthia OM, Porto G, Patel S, Kosnik-Infinger L, Eskandari R. Journal: World Neurosurg. 2024 Mar;183:e314-e320. doi: 10.1016/j.wneu.2023.12.090. Epub 2023 Dec 22. PMID: 38143033