Our Summary

The research paper discusses a study conducted on children with a condition called anorectal malformation (ARM), which is often associated with another condition called tethered spinal cord (TSC). The study aimed to understand the long-term outcomes of a surgery called ‘untethering’ for children with TSC.

The study included children who were at least 7 years old and had undergone ARM repair and spinal imaging between 1995 and 2008. All children who were found to have TSC underwent untethering surgery, regardless of whether they had any neurological symptoms. The researchers then compared the symptoms related to the rectum, urinary system, and lower limbs between children with and without TSC.

The results showed that symptoms related to the urinary system and lower limbs, except for one case of urinary reflux, improved after untethering surgery in the TSC group. The function of the rectum was similar in both groups.

The study concludes that the long-term outcomes of untethering surgery in children with ARM and TSC are as good as those in children without TSC. The researchers suggest that preventive untethering surgery may be a good treatment option for children with ARM and TSC to improve their neurological function.

FAQs

  1. What is the purpose of the untethering surgery mentioned in the study?
  2. What were the long-term outcomes of untethering surgery for children with anorectal malformation (ARM) and tethered spinal cord (TSC)?
  3. How did untethering surgery affect the symptoms related to the urinary system and lower limbs in children with ARM and TSC?

Doctor’s Tip

A helpful tip a doctor might tell a patient about detethering surgery is to ensure they follow their post-operative care instructions carefully. This may include restrictions on physical activity, wound care, and follow-up appointments to monitor for any complications. It is important for patients to communicate any new or worsening symptoms to their healthcare provider to ensure a successful recovery.

Suitable For

Patients who are typically recommended detethering surgery are those with tethered spinal cord (TSC) who are experiencing neurological symptoms or complications related to the spinal cord, such as changes in bladder or bowel function, weakness or numbness in the legs, or pain in the lower back or legs. In the case of the study mentioned above, children with anorectal malformation (ARM) and TSC were recommended detethering surgery to improve their long-term outcomes and prevent further neurological complications. It is important for patients to undergo thorough evaluation and consult with a healthcare provider to determine if detethering surgery is the appropriate treatment option for their condition.

Timeline

Before detethering surgery:

  1. Patient undergoes ARM repair surgery.
  2. Patient undergoes spinal imaging and is diagnosed with tethered spinal cord (TSC).
  3. Patient may experience symptoms related to the urinary system, lower limbs, and possibly neurological symptoms.

After detethering surgery:

  1. Patient undergoes untethering surgery to release the spinal cord.
  2. Symptoms related to the urinary system and lower limbs improve after surgery.
  3. Function of the rectum remains similar.
  4. Long-term outcomes of untethering surgery in children with ARM and TSC are found to be as good as those in children without TSC.
  5. Preventive untethering surgery may be considered as a treatment option for children with ARM and TSC to improve neurological function.

What to Ask Your Doctor

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

  1. What are the potential risks and complications associated with detethering surgery?
  2. How long is the recovery process after detethering surgery?
  3. Will I need physical therapy or rehabilitation after the surgery?
  4. How likely is it that my symptoms will improve after detethering surgery?
  5. Are there any alternative treatments or therapies that I should consider before undergoing detethering surgery?
  6. What is the success rate of detethering surgery for patients with my specific condition?
  7. How long do the effects of detethering surgery typically last?
  8. Will I need to undergo further surgeries or treatments in the future after detethering surgery?
  9. Are there any lifestyle changes or restrictions I should be aware of after detethering surgery?
  10. Can you provide me with more information or resources about detethering surgery and its potential benefits for my condition?

Reference

Authors: Inoue M, Uchida K, Otake K, Nagano Y, Shimura T, Hashimoto K, Matsushita K, Koike Y, Matsubara T, Kusunoki M. Journal: Pediatr Surg Int. 2017 Sep;33(9):995-999. doi: 10.1007/s00383-017-4127-y. Epub 2017 Aug 4. PMID: 28779274