Our Summary

This study aimed to understand the impact of tethered cord syndrome (TCS) on the digestive system in children, particularly focusing on the movement and function of the rectum and large intestine. This condition was compared to functional constipation (FC), a common issue in children. The researchers looked at medical records of children with TCS who had undergone a specific type of test (anorectal manometry or ARM) at their hospital over a 12 year period. They also collected information on patient characteristics, medical and surgical history, symptoms, and treatment at the time of the test. They then compared these results to similar children who only had FC.

The study found that the function of the rectum and large intestine in children with TCS was similar to those with FC. This was true whether or not the children with TCS had undergone surgery to correct their condition. These findings suggest that the root cause of digestive issues may be similar in children with TCS and those with FC.

FAQs

  1. What is the aim of this study on tethered cord syndrome (TCS) in children?
  2. How does the function of the rectum and large intestine in children with TCS compare to those with functional constipation (FC)?
  3. Does surgery to correct tethered cord syndrome (TCS) in children affect the function of the rectum and large intestine?

Doctor’s Tip

A helpful tip a doctor might tell a patient about detethering surgery is to follow up with a gastrointestinal specialist if they continue to experience digestive issues after the surgery. It is important to address any ongoing symptoms and work with a specialist to develop a treatment plan that may include dietary changes, medications, or other interventions to improve digestive function. Regular monitoring and communication with healthcare providers can help ensure the best possible outcomes following detethering surgery.

Suitable For

Patients who are typically recommended detethering surgery are those who have been diagnosed with tethered cord syndrome (TCS) and are experiencing symptoms such as back pain, leg weakness or numbness, changes in bowel or bladder function, scoliosis, or foot deformities. Additionally, patients who have not responded to conservative treatments such as physical therapy or medication may also be recommended for detethering surgery. It is important for patients to undergo a thorough evaluation by a neurosurgeon or spinal specialist to determine if detethering surgery is the appropriate treatment option for their condition.

Timeline

Before detethering surgery, a patient with tethered cord syndrome may experience symptoms such as back pain, leg weakness, bladder or bowel dysfunction, and changes in gait or posture. They may undergo diagnostic tests such as MRI or ultrasound to confirm the diagnosis of TCS.

After detethering surgery, the patient may experience a period of recovery in the hospital, with monitoring of symptoms and pain management. Physical therapy may be recommended to help with rehabilitation and regain strength and mobility. Follow-up appointments with the surgeon and neurologist will be scheduled to monitor progress and address any concerns. Over time, the patient may see improvements in their symptoms such as decreased pain, improved bladder and bowel function, and better mobility. Regular medical follow-ups will be necessary to ensure the long-term success of the surgery and to address any potential complications.

What to Ask Your Doctor

  1. What is detethering surgery and how does it help with tethered cord syndrome?
  2. What are the potential risks and complications associated with detethering surgery?
  3. How long is the recovery period after detethering surgery and what can I expect during the recovery process?
  4. What are the success rates of detethering surgery in improving symptoms related to tethered cord syndrome?
  5. Are there any long-term effects or implications of detethering surgery that I should be aware of?
  6. What alternative treatment options are available for tethered cord syndrome if I decide not to undergo detethering surgery?
  7. Will I need any additional tests or procedures before undergoing detethering surgery?
  8. How experienced are you in performing detethering surgery and what is your success rate with this procedure?
  9. Can you provide me with information on other patients who have undergone detethering surgery and their outcomes?
  10. What steps can I take to prepare for detethering surgery and optimize my chances for a successful outcome?

Reference

Authors: van der Zande JMJ, Srinivas S, Koppen IJN, Benninga MA, Wood RJ, Sanchez RE, Puri NB, Vaz K, Yacob D, Di Lorenzo C, Lu PL. Journal: J Pediatr Gastroenterol Nutr. 2024 Nov;79(5):976-982. doi: 10.1002/jpn3.12357. Epub 2024 Aug 29. PMID: 39206742