Surgical Outcome of Adolescents and Young Children with Tethered Cord Syndrome: A Retrospective Analysis

  • Ayaz Ahmad Department of Neurosurgery, Hayatabad Medical Complex
  • Muhammad Ali Noman Department of Neurosurgery, Hayatabad Medical Complex
  • Muhammad Mukhtar North West General Hospital & Research Hospital Peshawar – Pakistan
  • Imran Khan North West General Hospital & Research Hospital Peshawar – Pakistan
  • Muhammad Mushtaq North West General Hospital & Research Hospital Peshawar – Pakistan
  • Shahid Ayub Department of Neurosurgery, Hayatabad Medical Complex
Keywords: Spinal Dysraphism, Spina bifida Occulta, Tethered Cord Syndrome

Abstract

Objective:  In Spinal dysraphism, neural tube defect is one of the leading causes of congenital central nervous system disorders and contributes to a high proportion of disability and mortality. This study aimed to evaluate the outcome of the detethering of tethered cord syndrome.

Materials & Methods:  The study was conducted at the Neurosurgery Department of Hayatabad Medical Complex Peshawar. A total of 110 patients were included in our study. Clinical examination was recorded for back swelling, dermal stigmata, scars, lower limb neurological function, sensory deficits, reflexes. Also, look for any deformities like kyphoscoliosis or limb deformities and the presence/absence of neuropathic ulcers. Imaging studies were recorded for diagnosis, the level of spinal tethering, presence/absence of syrinx, and spine deformities. During the surgical operation, the diagnosis of the lesion was confirmed and the interventional procedure was recorded.

Results:  One hundred ten patients were admitted during the study period with 57 (52.2%) females and 53 (47.8%) males with a mean age of 9.3 years (SD ± 4.3). Most patients had presented with pain in lower limbs (60.9%) and backache was (34.8%). The most common operative complication was CSF leak in 29 patients (26.1%) while wound infection occurred in 14 (13%) cases.

Conclusion:  Tethered cord syndrome due to occult spinal dysraphism is a rare disease with significant neurologic consequences for the younger generation. Early clinical diagnosis and good surgical treatment could prevent the development of these complications.

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Published
2021-10-16
Section
Original Articles