Our Summary

This research was designed to test a new technique during surgery for spinal cord disorders, specifically tethered cord syndrome and spinal dysraphism. The new technique involves placing a strip of electrodes near the surgical area to monitor sensory nerve activity. In doing so, the goal is to identify and preserve the important sensory nerves during surgery, thereby preventing any potential loss of function post-surgery.

The study involved six patients aged between 0.5 to 16 years, who were undergoing surgery for the named spinal disorders. In addition to the regular surgical preparations, these patients had the electrode strip inserted and secured by the surgeon after opening the protective covering of the spinal cord.

During the surgery, the sensory nerves were stimulated and the responses were recorded using the electrodes. These recordings allowed the surgeons to identify any sensory nerves that still had function, as well as the most inferior functional part of the conus medullaris, which is the tapered end of the spinal cord.

The results showed that the responses to sensory nerve stimulation were often much larger than those to conus stimulation. The use of these recordings, along with the regular surgical procedures, allowed the surgeons to successfully complete the detethering surgery without causing any new functional deficits in the patients.

In conclusion, this study suggests that using subdural strip electrodes to monitor sensory nerve activity during detethering surgery can be a valuable tool for maximizing surgical success and preserving important sensory functions, which in turn helps maintain the patient’s quality of life.

FAQs

  1. What is the new technique being tested for surgeries for spinal cord disorders?
  2. How does the use of electrodes during surgery help preserve sensory nerves and prevent loss of function post-surgery?
  3. What were the results and conclusion of the study on using subdural strip electrodes during detethering surgery?

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 any prescribed medications, attending follow-up appointments, and avoiding strenuous activities as recommended. It is important to communicate any concerns or changes in symptoms to your healthcare provider to ensure a successful recovery.

Suitable For

Patients who are typically recommended detethering surgery include those with tethered cord syndrome and spinal dysraphism. These conditions can lead to symptoms such as back pain, leg weakness or numbness, bladder or bowel dysfunction, and changes in gait. Surgery is often recommended to release the spinal cord from abnormal attachments and prevent further neurological deficits.

In this study, patients aged between 0.5 to 16 years underwent detethering surgery with the new technique of using subdural strip electrodes to monitor sensory nerve activity. This technique was found to be effective in identifying and preserving important sensory nerves during surgery, ultimately preventing any potential loss of function post-surgery.

Overall, detethering surgery is recommended for patients with tethered cord syndrome and spinal dysraphism who are experiencing symptoms and who would benefit from releasing the spinal cord from abnormal attachments. The use of innovative techniques, such as monitoring sensory nerve activity with electrodes, can improve surgical outcomes and preserve important sensory functions, ultimately enhancing the quality of life for these patients.

Timeline

Before detethering surgery:

  • Patient presents with symptoms such as back pain, leg weakness, bladder dysfunction, and sensory changes
  • Patient undergoes medical evaluations, imaging tests, and consultations with neurosurgeons
  • Diagnosis of tethered cord syndrome or spinal dysraphism is confirmed
  • Surgical plan is discussed and finalized with the patient and their family

After detethering surgery:

  • Patient undergoes surgery with the new technique of using subdural strip electrodes to monitor sensory nerve activity
  • Surgeons successfully complete the detethering surgery without causing any new functional deficits
  • Patient is monitored closely in the hospital for any complications and to ensure proper healing
  • Patient undergoes physical therapy and rehabilitation to regain strength and function
  • Follow-up appointments are scheduled to monitor the patient’s progress and address any concerns or issues that may arise

What to Ask Your Doctor

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

  1. What is the purpose of using subdural strip electrodes during the surgery?
  2. How will the monitoring of sensory nerve activity with electrodes benefit me during the surgery?
  3. What are the potential risks or complications associated with using this new technique?
  4. How will the information gathered from the electrode recordings be used to guide the surgical procedure?
  5. Will the use of electrodes increase the length or complexity of the surgery?
  6. How likely is it that this new technique will prevent any loss of sensory function post-surgery?
  7. Are there any specific pre-operative preparations or post-operative care instructions related to the use of electrodes during surgery?
  8. What is the success rate of this new technique in preventing new functional deficits in patients undergoing detethering surgery?
  9. Are there any long-term implications or considerations to be aware of regarding the use of electrodes during the surgery?
  10. Can you provide any additional information or resources for me to learn more about this new technique and its potential benefits for my specific case?

Reference

Authors: Yang CY, Liang ML, Chen HH, Chiu JW, Liao KK, Yang TF. Journal: J Neurosurg Spine. 2018 Oct;29(4):456-460. doi: 10.3171/2018.2.SPINE171240. Epub 2018 Jul 13. PMID: 30004314