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The effect of tethered cord release on coronal spinal balance in tight filum terminale.
Spine (Phila Pa 1976). 2011 Jun 15; 36(14):E944-9.S

Abstract

STUDY DESIGN

A retrospective review of coronal spine balance after tethered cord release for children with tight filum terminale.

OBJECTIVE

To understand the effects of untethering on coronal spine balance for these patients.

SUMMARY OF BACKGROUND DATA

In patients with tight filum terminale, the spinal cord is tethered by a thickened filum with a low conus medullaris but without other forms of spinal dysraphism. There have not been studies examining the effects of spinal cord untethering on coronal spinal alignment in children with tight filum terminale.

METHODS

Forty-five consecutive pediatric patients with tight filum terminale who had undergone untethering were evaluated. Their presenting signs and symptoms, pre- and postsurgery imagings, and clinical courses were reviewed for scoliosis progression.

RESULTS

Twenty-six girls and 19 boys underwent tethered cord release at a mean age of 4.5 years. The prevalence of coronal spinal malalignment, manifesting as scoliosis, before the untethering procedure was 31% (14 of 45). During the follow-up period, nine patients had coronal spinal alignment that worsened>10° (five patients eventually underwent surgical fusion), two patients had spinal alignment that improved, and five patients' curves stabilized after untethering surgery. Therefore, at the end of the follow-up period, 9 of 45 patients (20%) had worsened coronal spinal alignment. In the multivariate analysis, patients who presented with a Cobb angle greater than 35° were most likely to progress (P=0.002, odds ratio=21). There was no operative morbidity or mortality associated with scoliosis surgery.

CONCLUSION

A significant number of children with tight filum terminale were found to present with scoliosis. In patients with less severe curves, tethered cord release may halt scoliosis progression.

Authors+Show Affiliations

Neuro-spine Program, Division of Pediatric Neurosurgery, Texas Children's Hospital, Department of Neurosurgery, Baylor College of Medicine, Houston, Texas, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21289577

Citation

Chern, Joshua J., et al. "The Effect of Tethered Cord Release On Coronal Spinal Balance in Tight Filum Terminale." Spine, vol. 36, no. 14, 2011, pp. E944-9.
Chern JJ, Dauser RC, Whitehead WE, et al. The effect of tethered cord release on coronal spinal balance in tight filum terminale. Spine. 2011;36(14):E944-9.
Chern, J. J., Dauser, R. C., Whitehead, W. E., Curry, D. J., Luerssen, T. G., & Jea, A. (2011). The effect of tethered cord release on coronal spinal balance in tight filum terminale. Spine, 36(14), E944-9. https://doi.org/10.1097/BRS.0b013e3181fc2edd
Chern JJ, et al. The Effect of Tethered Cord Release On Coronal Spinal Balance in Tight Filum Terminale. Spine. 2011 Jun 15;36(14):E944-9. PubMed PMID: 21289577.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of tethered cord release on coronal spinal balance in tight filum terminale. AU - Chern,Joshua J, AU - Dauser,Robert C, AU - Whitehead,William E, AU - Curry,Daniel J, AU - Luerssen,Thomas G, AU - Jea,Andrew, PY - 2011/2/4/entrez PY - 2011/2/4/pubmed PY - 2011/10/5/medline SP - E944 EP - 9 JF - Spine JO - Spine VL - 36 IS - 14 N2 - STUDY DESIGN: A retrospective review of coronal spine balance after tethered cord release for children with tight filum terminale. OBJECTIVE: To understand the effects of untethering on coronal spine balance for these patients. SUMMARY OF BACKGROUND DATA: In patients with tight filum terminale, the spinal cord is tethered by a thickened filum with a low conus medullaris but without other forms of spinal dysraphism. There have not been studies examining the effects of spinal cord untethering on coronal spinal alignment in children with tight filum terminale. METHODS: Forty-five consecutive pediatric patients with tight filum terminale who had undergone untethering were evaluated. Their presenting signs and symptoms, pre- and postsurgery imagings, and clinical courses were reviewed for scoliosis progression. RESULTS: Twenty-six girls and 19 boys underwent tethered cord release at a mean age of 4.5 years. The prevalence of coronal spinal malalignment, manifesting as scoliosis, before the untethering procedure was 31% (14 of 45). During the follow-up period, nine patients had coronal spinal alignment that worsened>10° (five patients eventually underwent surgical fusion), two patients had spinal alignment that improved, and five patients' curves stabilized after untethering surgery. Therefore, at the end of the follow-up period, 9 of 45 patients (20%) had worsened coronal spinal alignment. In the multivariate analysis, patients who presented with a Cobb angle greater than 35° were most likely to progress (P=0.002, odds ratio=21). There was no operative morbidity or mortality associated with scoliosis surgery. CONCLUSION: A significant number of children with tight filum terminale were found to present with scoliosis. In patients with less severe curves, tethered cord release may halt scoliosis progression. SN - 1528-1159 UR - https://www.unboundmedicine.com/medline/citation/21289577/The_effect_of_tethered_cord_release_on_coronal_spinal_balance_in_tight_filum_terminale_ L2 - http://dx.doi.org/10.1097/BRS.0b013e3181fc2edd DB - PRIME DP - Unbound Medicine ER -