Advertisement

Child's Nervous System

, Volume 13, Issue 5, pp 268–274 | Cite as

Surgical treatment supposed natural history of the tethered cord with occult spinal dysraphism

  • I. Koyanagi
  • Yoshinobu Iwasaki
  • Kazutoshi Hida
  • Hiroshi Abe
  • T. Isu
  • M. Akino
ORIGINAL PAPER

Abstract

We retrospectively evaluated the pre- and postoperative course of 34 tethered cord patients with occult spinal dysraphism in an attempt to infer the natural history of this disorder and to determine the effectiveness of the surgical treatment. There were 32 cases with lumbosacral lipoma and 2 with tight filum terminale. The age at surgery ranged from 1 month to 47 years old. Eight patients, aged 1 month to 4 years old, were asymptomatic; 26 had neurogenic bladder (26 cases) or motor problems affecting the legs (8 cases). None of the patients older than 5 years of age were asymptomatic. Untethering of the spinal cord was performed in all cases. The postoperative follow-up period ranged from 5 months to 11 years. During these periods, 7 (88%) of the 8 asymptomatic patients remained neurologically intact, 6 (23%) of the 26 symptomatic patients showed improved symptoms, and 15 patients (58%) remained unchanged. These results indicate that the neurological symptoms will appear progressively in the tethered cord patients, and that prophylactic surgery should be considered as early as possible.

Key words Occult spinal dysraphism Tethered cord Lumbosacral lipoma Tight filum terminale Surgical treatment 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

Copyright information

© Springer-Verlag Berlin Heidelberg 1997

Authors and Affiliations

  • I. Koyanagi
    • 1
  • Yoshinobu Iwasaki
    • 1
  • Kazutoshi Hida
    • 1
  • Hiroshi Abe
    • 1
  • T. Isu
    • 1
  • M. Akino
    • 1
  1. 1.Department of Neurosurgery, Hokkaido University School of Medicine, Sapporo, JapanJP

Personalised recommendations