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Introduction of a urodynamic score to detect pre- and postoperative neurological deficits in children with a primary tethered cord

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Abstract

Object

An increasing number of asymptomatic children are diagnosed with occult spinal dysraphism, raising the question of their optimal management. Urodynamic study (UDS) is the most reliable method of detecting neuro-urological abnormalities in these children. The rate of postoperative retethering ranges from 10 to 20% and is not always immediately clinically significant. The aim of this prospective study was to develop a reliable method that could be used in the preoperative assessment and postoperative follow-up of children with a tethered cord syndrome (TCS).

Methods

From 1989 to 1997, 15 children underwent spinal cord untethering for TCS. Preoperatively, patients were assessed with MRI and UDS. Postoperative UDS were repeated at 6- to 12-month intervals. Four UDS parameters were identified, graded, and added to obtain a UDS score. A group of 38 children without dysraphic condition was used as control and allowed the calculation of a normal score.

Conclusions

There was a statistically significant difference in the preoperative UDS scores between the control group and the study group (p<0.001). Postoperatively, there was a statistically significant improvement (p<0.001) in UDS scores. UDS score is a reliable tool for identifying and quantifying neuro-urological disorders in patients with TCS. Postoperatively, this score was useful in the early diagnosis of spinal cord retethering.

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Authors and Affiliations

  1. Department of Pediatric Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland

    Blaise Julien Meyrat, Stéphan Tercier & Nicolas Lutz

  2. Department of Neurosurgery, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland

    Bénédict Rilliet & Olivier Vernet

  3. Division of Neonatology, Department of Pediatrics, Centre Hospitalier Universitaire Vaudois (CHUV), 1011, Lausanne, Switzerland

    Margarita Forcada-Guex

Authors
  1. Blaise Julien Meyrat
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  2. Stéphan Tercier
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  3. Nicolas Lutz
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  4. Bénédict Rilliet
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  5. Margarita Forcada-Guex
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  6. Olivier Vernet
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Correspondence to Blaise Julien Meyrat.

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Meyrat, B.J., Tercier, S., Lutz, N. et al. Introduction of a urodynamic score to detect pre- and postoperative neurological deficits in children with a primary tethered cord. Childs Nerv Syst 19, 716–721 (2003). https://doi.org/10.1007/s00381-003-0829-7

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  • DOI: https://doi.org/10.1007/s00381-003-0829-7

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