Microsurgical release of tethered spinal cord in pediatric patients: analysis on therapeutic effects

Abstract

Objective To summarize and analyze the therapeutic effects of microsurgical release on pediatric patients with tethered spinal cord.Methods Eighty hospitalized patients with conus and cauda equina symptoms were included in this study.Their MRI showed lumbosacral laminectomy defect,spinal low,terminal filament thickening and spinal cord end mass.All cases received microsurgical release operation including resection of the meningocele sac and lumbosacral intraspinal lesion.Among which,28 patients underwent the electrophysiological monitoring for the functions of conus and cauda equine in operation.Post - operational follow - up were obtained for 67 cases.Results The 69％ children self - evaluated an alleviation and mitigation for their symptoms.The 62％ cases improved in the cases with abnormality of defecation and urination.Among those with sensory,motor,lower extremities development and nutrition disorders,45％ improved sensory functions and 28％ motor functions.The follow - up showed that 79％ self - evaluated significant improvements in defecation and urination post - operationally than pre -operationally,and 63％ claimed significant improvements in sensory and motor functions.The symptomatic improvement rate by self - evaluation was significantly higher in those who obtained intra -operational electrophysiological monitoring than those who did not.Conclusion The microdissection technique and neural electrophysiological monitoring method are key factors for obtaining better therapeutic effects of microsurgical release on pediatric patients with tethered spinal cord. Key words: Tethered cord syndrome; Microsurgery; Neural electrophysiological monitoring; Child