A simple method to deter retethering in patients with spinal dysraphism

Abstract

The authors describe a technique that may be of benefit to patients with spinal dysraphism and a tethered spinal cord. Twenty pediatric patients (ten initial operations and ten reoperations) after the detethering of their spinal cord had intradural retention sutures placed with subsequent duraplasty using autologous thoracolumbar fascia. To date, no patient has had signs or symptoms or recurrence of signs or symptoms of a tethered spinal cord. No complications have resulted from this maneuver. The mean follow-up time for this cohort was 8 years. The advantages of this intervention include maintaining a relatively normal position of the spinal cord within the thecal sac, thus decreasing the potential adherence of the dorsally scarred aspect of the dysmorphic cord to an overlying graft whether synthetic or native.