دورية أكاديمية
Prophylactic Spinal Cord Untethering in Children with Spinal Dysraphism Undergoing Thoracolumbar Fusion for Scoliosis.
| العنوان: | Prophylactic Spinal Cord Untethering in Children with Spinal Dysraphism Undergoing Thoracolumbar Fusion for Scoliosis. |
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| المؤلفون: | Bureau BL; Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Sherburne E; Department of Nursing Research, Children's Wisconsin, Milwaukee, Wisconsin, USA., Thometz JG; Department of Orthopedic Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA., Foy AB; Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA. Electronic address: afoy@mcw.edu. |
| المصدر: | World neurosurgery [World Neurosurg] 2023 Oct; Vol. 178, pp. e427-e430. Date of Electronic Publication: 2023 Jul 26. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Country of Publication: United States NLM ID: 101528275 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1878-8769 (Electronic) Linking ISSN: 18788750 NLM ISO Abbreviation: World Neurosurg Subsets: MEDLINE |
| أسماء مطبوعة: | Original Publication: New York : Elsevier |
| مواضيع طبية MeSH: | Scoliosis*/complications , Scoliosis*/surgery , Scoliosis*/epidemiology , Meningomyelocele*/surgery , Neural Tube Defects*/complications , Neural Tube Defects*/surgery , Neural Tube Defects*/epidemiology , Spina Bifida Occulta* , Spinal Fusion*, Humans ; Child ; Adolescent ; Retrospective Studies ; Spinal Cord/surgery ; Treatment Outcome |
| مستخلص: | Background: It remains unclear whether spinal cord untethering is necessary to reduce the chances of neurologic decline in children with myelomeningocele and complex closed spinal dysraphism who undergo thoracolumbar fusion for scoliosis. We sought to determine the neurologic and functional outcomes of children with spinal dysraphism undergoing spinal fusion for scoliosis with and without prophylactic spinal cord untethering. Methods: Retrospective, single-center review of patients with spinal dysraphism treated with thoracolumbar fusion over the last 10 years (2009-2019) with or without prophylactic spinal cord untethering. Results: Seventeen patients with myelomeningocele and complex closed spinal dysraphism underwent spinal fusion for scoliosis. Mean age at time of surgery was 13.9 years. Prophylactic spinal cord untethering was performed in 8 of 17 (47%) patients. The change in Cobb angle after surgery was similar between the 2 groups (19.4° untethered vs. 19.9° no untethering). The ambulatory status was similar between the groups, with 37% of the untethered cohort and 44% of the non-untethered cohort being community or household ambulators. There were no changes in intraoperative motor or sensory evoked potentials in any patient during fusion surgery. No patient had a change in motor level or ambulatory status after scoliosis surgery. Conclusions: Our data suggest that prophylactic spinal cord untethering in children with spinal dysraphism undergoing thoracolumbar fusion for scoliosis may not be necessary in patients with moderate curvatures. Our conclusions are limited by the small sample size. A larger review of registry data may yield more powerful conclusions on the necessity of prophylactic spinal cord untethering in this patient population. (Copyright © 2023 Elsevier Inc. All rights reserved.) |
| معلومات مُعتمدة: | U01 DD001240 United States DD NCBDD CDC HHS |
| فهرسة مساهمة: | Keywords: Myelomeningocele; Scoliosis; Spina bifida; Spinal dysraphism; Spinal fusion |
| تواريخ الأحداث: | Date Created: 20230727 Date Completed: 20231009 Latest Revision: 20240626 |
| رمز التحديث: | 20240626 |
| DOI: | 10.1016/j.wneu.2023.07.088 |
| PMID: | 37499752 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1878-8769 |
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| DOI: | 10.1016/j.wneu.2023.07.088 |