Our Summary

This research paper discusses a new surgical method for treating tethered cord syndrome, a condition caused by an abnormality in the filum terminale (a bundle of nerves at the end of the spinal cord). Traditionally, doctors cut the filum through a procedure at the lower back. However, this study proposes a different approach that cuts the filum at a higher point, below the tip of the spinal cord. This technique allows for the complete removal of the affected part of the filum through a less invasive approach, reducing leftover filum tissue that could potentially cause problems.

FAQs

  1. What is the new surgical method proposed for treating tethered cord syndrome?
  2. How does the new approach differ from the traditional method of cutting the filum?
  3. What are the potential benefits of this less invasive approach to detethering surgery?

Doctor’s Tip

A doctor may advise a patient undergoing detethering surgery to follow post-operative care instructions carefully, including avoiding heavy lifting or strenuous activity for a certain period of time, and attending follow-up appointments to monitor recovery progress. It is also important to communicate any new or worsening symptoms to the doctor promptly.

Suitable For

Patients who are typically recommended detethering surgery are those who experience symptoms of tethered cord syndrome, such as lower back pain, leg weakness or numbness, difficulty walking, bladder or bowel dysfunction, and scoliosis. These symptoms may be present from birth or develop later in life due to the tethered cord putting pressure on the spinal cord and nerves.

Patients with a tethered cord may also have other underlying conditions that contribute to their symptoms, such as spina bifida, spinal cord injury, or spinal cord tumors. In these cases, detethering surgery may be recommended to relieve pressure on the spinal cord and improve overall function.

It is important for patients to undergo thorough evaluation and imaging studies to determine if they are suitable candidates for detethering surgery. The decision to proceed with surgery is typically based on the severity of symptoms, the extent of tethering, and the potential for improvement in symptoms and function following surgery.

Overall, patients who are experiencing symptoms of tethered cord syndrome and have been diagnosed with a tethered cord through imaging studies are typically recommended for detethering surgery to alleviate symptoms and prevent further complications.

Timeline

Before detethering surgery:

  • Patient experiences symptoms such as lower back pain, leg weakness, numbness or tingling in the legs, difficulty walking, and incontinence.
  • Patient undergoes diagnostic tests such as MRI or CT scans to confirm the diagnosis of tethered cord syndrome.
  • Patient and their healthcare team discuss treatment options, including detethering surgery, to relieve symptoms and prevent further neurological damage.

After detethering surgery:

  • Patient undergoes pre-operative preparation, including fasting and anesthesia administration.
  • Surgeon performs the detethering surgery by cutting the filum terminale at a higher point, below the tip of the spinal cord.
  • Patient is closely monitored in the post-operative period for any complications or side effects.
  • Patient may experience some pain and discomfort in the surgical area, which can be managed with pain medication.
  • Patient undergoes physical therapy and rehabilitation to regain strength and function in the legs.
  • Patient may experience improvements in symptoms such as decreased pain, improved mobility, and better bladder and bowel control.
  • Patient follows up with their healthcare team for regular check-ups to monitor their recovery progress and address any concerns.

What to Ask Your Doctor

  1. What is the success rate of detethering surgery using this new technique compared to traditional methods?
  2. What are the potential risks and complications associated with detethering surgery?
  3. How long is the recovery process after detethering surgery?
  4. Will I need physical therapy or rehabilitation after the surgery?
  5. How long will I need to stay in the hospital after the surgery?
  6. What is the long-term outlook for patients who undergo detethering surgery?
  7. Will I need any additional follow-up appointments or treatments after the surgery?
  8. Are there any lifestyle changes or restrictions I should be aware of post-surgery?
  9. How soon can I expect to see improvement in my symptoms after the surgery?
  10. Are there any alternative treatments or therapies that may be beneficial for my condition in addition to surgery?

Reference

Authors: Abdulrazeq H, Shao B, Sastry RA, Klinge PM. Journal: Acta Neurochir (Wien). 2023 Nov;165(11):3505-3509. doi: 10.1007/s00701-023-05568-9. Epub 2023 Apr 5. PMID: 37017726