Our Summary

This study presents a new way of identifying and preserving important nerve roots during surgery for a specific type of spina bifida (a birth defect where the spinal cord doesn’t develop properly). The technique involves using a tool called an electrified cavitron ultrasonic aspirator (eCUSA) to send electric signals into the area being operated on. These signals help the surgeon to identify where the nerve roots are, and which ones are functioning. The study included 20 children with spina bifida, and the results showed that this new technique was successful in helping to preserve these nerve roots in a majority of the cases. The authors suggest that this method could improve the safety of the surgery, but more research is needed to understand the long-term outcomes for patients.

FAQs

  1. What is the new technique being used during surgery for spina bifida?
  2. How does the electrified cavitron ultrasonic aspirator (eCUSA) help surgeons during the operation?
  3. What were the results of the study and how might this method improve the safety of the surgery?

Doctor’s Tip

A doctor may advise a patient undergoing detethering surgery to follow post-operative care instructions carefully, including avoiding strenuous activities and lifting heavy objects for a certain period of time to allow for proper healing. It is also important for the patient to attend follow-up appointments and communicate any new or worsening symptoms to their healthcare provider. Additionally, physical therapy may be recommended to help with rehabilitation and improve mobility after surgery.

Suitable For

Patients who are typically recommended detethering surgery include those with spina bifida, tethered spinal cord syndrome, and other conditions where the spinal cord is abnormally attached to surrounding tissues. Symptoms of tethered spinal cord syndrome may include back pain, leg weakness or numbness, urinary incontinence, and difficulty walking. Patients who have progressive neurological deficits, worsening symptoms, or signs of spinal cord damage may be candidates for detethering surgery. It is important for patients to undergo a thorough evaluation by a neurosurgeon to determine if detethering surgery is the appropriate treatment option for their condition.

Timeline

Before detethering surgery:

  1. Diagnosis of spina bifida is made through imaging tests such as MRI or ultrasound.
  2. Symptoms such as back pain, leg weakness, bladder or bowel dysfunction, and difficulty walking may develop.
  3. Non-surgical treatments such as physical therapy, medications, and monitoring of symptoms are often recommended.
  4. If symptoms worsen or do not improve with conservative treatments, surgery may be recommended to detether the spinal cord.

After detethering surgery:

  1. The patient will undergo pre-operative evaluations and tests to assess their overall health and readiness for surgery.
  2. The surgery is performed to release the tethered spinal cord and preserve important nerve roots using techniques such as the eCUSA tool.
  3. Recovery time in the hospital typically ranges from a few days to a week, depending on the complexity of the surgery and the patient’s overall health.
  4. Physical therapy and rehabilitation may be needed to help the patient regain strength, mobility, and function.
  5. Follow-up appointments with the surgeon and other healthcare providers will be scheduled to monitor the patient’s progress and address any complications or concerns.
  6. Long-term outcomes may vary, but some patients may experience improvements in symptoms such as pain, mobility, and bladder or bowel function.

What to Ask Your Doctor

  1. What is detethering surgery, and why is it recommended for my condition?
  2. What are the potential risks and complications associated with detethering surgery?
  3. How experienced are you in performing detethering surgery, and what is your success rate?
  4. What is the recovery process like after detethering surgery, and what kind of follow-up care will be needed?
  5. Can you explain the use of the electrified cavitron ultrasonic aspirator (eCUSA) during the surgery and how it helps in preserving nerve roots?
  6. How will you determine which nerve roots to preserve during the surgery, and what factors will you consider?
  7. Are there any alternative treatments or surgical techniques that could be considered for my condition?
  8. What are the potential long-term outcomes and benefits of preserving nerve roots during detethering surgery?
  9. How will you monitor and assess the functioning of the preserved nerve roots post-surgery?
  10. Are there any specific lifestyle changes or precautions I should take after detethering surgery to ensure optimal recovery and outcomes?

Reference

Authors: Sapir Y, Buzaglo N, Korn A, Constantini S, Roth J, Rochkind S. Journal: Childs Nerv Syst. 2021 May;37(5):1633-1639. doi: 10.1007/s00381-020-05012-8. Epub 2021 Jan 6. PMID: 33404721