Our Summary

Tethered cord syndrome (TCS) is a condition that often leads to nerve and urinary problems. The main treatment for it is a type of surgery called ‘detethering’. This research looked at how this surgery affects urinary function in children.

The researchers looked at the medical records of 46 kids who had had the surgery. They looked at things like bladder capacity, how much urine was left in the bladder after peeing, and the pressure inside the bladder before and after the operation.

They found that after surgery, bladder capacity and the amount of leftover urine decreased, while bladder pressure and compliance (how well the bladder can expand and contract) increased. The changes in bladder capacity and pressure seemed to be more significant in kids older than 10.

In conclusion, the surgery seems to affect bladder function quite a bit in kids with TCS. But it seems that kids older than 10 might get the most benefit from the operation.

FAQs

  1. What is tethered cord syndrome (TCS) and how is it treated?
  2. How does detethering surgery affect urinary function in children with TCS?
  3. Does the age of the child with TCS have an impact on the benefits of detethering surgery?

Doctor’s Tip

A doctor might tell a patient considering detethering surgery that the procedure can have a positive impact on bladder function, particularly in older children. It is important to discuss the potential benefits and risks with your healthcare provider to determine if the surgery is the best option for you or your child. Additionally, post-operative care and rehabilitation may be necessary to optimize bladder function and overall recovery.

Suitable For

Patients who are typically recommended detethering surgery are those with symptoms of tethered cord syndrome, such as:

  • Back pain
  • Leg weakness or numbness
  • Changes in bowel or bladder function
  • Difficulty walking or coordination issues
  • Scoliosis or other spine abnormalities

Children with TCS may also experience urinary problems, such as urinary incontinence, urinary retention, or frequent urinary tract infections. These symptoms can be improved or resolved with detethering surgery, as shown by the research mentioned above.

Overall, detethering surgery is recommended for patients with TCS who are experiencing neurological and urinary symptoms that are impacting their quality of life and daily functioning. It is important for patients to consult with a neurosurgeon or other medical specialist to determine if detethering surgery is the best treatment option for their specific condition.

Timeline

Before detethering surgery:

  • Patient may experience symptoms of TCS such as back pain, leg weakness, urinary problems, and/or difficulty walking
  • Patient undergoes diagnostic tests such as MRI or ultrasound to confirm diagnosis of TCS
  • Treatment options are discussed with the patient and their family, including the option of detethering surgery

After detethering surgery:

  • Patient undergoes surgery to release the tethered spinal cord
  • Patient may experience pain and discomfort following the surgery
  • Patient may need to stay in the hospital for a few days for monitoring and recovery
  • Patient may need physical therapy to regain strength and mobility
  • Patient may need follow-up appointments with their healthcare provider to monitor their progress and address any complications or concerns

What to Ask Your Doctor

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

  1. What is the purpose of detethering surgery for TCS?
  2. What are the potential risks and complications associated with the surgery?
  3. How long is the recovery process after detethering surgery?
  4. Will the surgery improve my bladder function and urinary problems?
  5. How will the surgery affect my child’s bladder capacity, bladder pressure, and compliance?
  6. What is the success rate of detethering surgery for TCS?
  7. Are there any alternative treatments or therapies for TCS that we should consider?
  8. What is the long-term outlook for a child who undergoes detethering surgery?
  9. How often will follow-up appointments be needed after the surgery?
  10. Are there any lifestyle changes or restrictions that will need to be implemented after the surgery?

Reference

Authors: Geyik M, Geyik S, Şen H, Pusat S, Alptekin M, Yılmaz AE, Nazik M, Erkutlu İ. Journal: Childs Nerv Syst. 2016 Jun;32(6):1079-84. doi: 10.1007/s00381-016-3053-y. Epub 2016 Mar 11. PMID: 26969174