Homogeneous spinal-shortening axial decompression as a revision surgery after untethering surgery in child patients with tethered cord syndrome.

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Homogeneous spinal-shortening axial decompression as a revision surgery after untethering surgery in child patients with tethered cord syndrome.

World Neurosurg. 2019 Jan 17;:

Authors: Wang H, Xu T, Wang Y, Sun K, Xu X, Zhang B, Guo Y, Sun J, Shi J

Abstract
OBJECTIVE: The aim of this study was to evaluate the surgical outcomes of homogeneous spinal-shortening axial decompression (HSAD) for the reoperation in child patients with tethered cord syndrome.
METHODS: Between June 2012 and May 2015, A total of consecutive 20 child patients (≤18-year-age,7 males, 13 females) who underwent HSAD after untethering surgery were included. The Japanese Orthopaedic Association (JOA)score and Visual analogue scale (VAS) were used to evaluate pre- and post-operative neurological function and pain. The short form of International Consultation on Incontinence questionnaire ( ICI-Q-SF) and urodynamics were used to evaluate the urinary function. The Rintala score was used to evaluate the stool function.
RESULTS: The mean age of the patients was 13.4±3.6 years (range 7-18 years). The mean duration of follow-up was 31.2±12.7 months (range 12-48 months). The JOA score was increased from preoperative 13.31±4.03 to 19.15±4.17 at final follow-up(p<0.01). The VAS score was decreased from preoperative 5.25±1.78 to 2.21±1.63 at final follow-up(p<0.01).The ICI-Q-SF scores was decreased from preoperative 14.94±4.15 to 7.63±4.40 at final follow-up(p<0.01). All the urodynamic parameters improved compared with those before operation; The Rintala scores was improved from preoperative 5.26±3.45 to 12.32±3.43 at final follow-up(p<0.01).
CONCLUSION: The outcomes of HSAD for the reoperation of TCS is satisfactory. HSAD could improve the patients' neurological function significantly, and it could become an alternative surgical treatment of the reoperation for TCS.

PMID: 30660897 [PubMed - as supplied by publisher]

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