Safety and Efficacy of Concurrent Pediatric Spinal Cord Untethering and Deformity Correction

• DOI: 10.1097/bsd.0b013e3182019f4d
• Publication Date: 2010-12-10T06:06:40Z
• Authors: Vivek A. Mehta; Oren N. Gottfried; Matthew J. McGirt; Ziya L. Gokaslan; Edward S. Ahn; George I. Jallo
• Keywords: Kyphosis; Cobb angle

A retrospective clinical records analysis of concurrent pediatric spinal cord deformity correction and tethered release compared with a 2-staged approach.To compare the safety efficacy single-staged approach for to conventional approach.Tethered syndrome (TCS) is frequently associated scoliosis in population. Conventional practice suggests waiting several months after untethering correction; however, some patients will experience progression their deformity. We report and/or kyphosis series patients.We retrospectively reviewed 15 consecutive cases fusion kyphosis. The radiologic presentation, operative details, morbidity, postoperative outcomes were evaluated. Outcomes this cohort then 21 who underwent surgery followed by correction. provide review literature treatment spine deformities.The mean age undergoing curve was 9.6 years (5 male, 10 female). Tethered because myelomeningocele patients), thickened filum terminale lipomyelomeningocele (4 retethering from an unknown primary TCS etiology (1 patient). Cobb angle (±SD) at presentation 55.4±21.0 degrees (range, 32.3 95.0 degrees) whereas average 112.7±43.6 68.0 155.0 degrees). Average 40.0 degrees, resulting 27%; 55.7 50%. operation time 8.6 hours 3.9 13.7 h) blood loss 1266 mL 400 5000 mL). length hospitalization 10.1 days 4 34 d). New onset or worsening neurologic deficits, bowel bladder dysfunction, pain did not occur any patients. At follow-up 5.7 1.3 11.8 y), only 1 (7%) patient required subsequent pseudoarthrosis. experienced longer cumulative (11.2 vs h, P<0.05), more total (1534 mL, (14.8 d, greater incidence dural tear (9.5% 0%), wound infection (26% 0%).Concurrent may be safe effective likely progression.