Clinical evaluation of an innovative operative procedure in treatment of the tethered cord syndrome.

Publication date: Available online 18 October 2017
Source:The Spine Journal
Author(s): Yang Hou, Jiangang Shi, Yongfei Guo, Jingchuan Sun, Yuan Wang, Guodong Shi, Guohua Xu
Background ContextThe Tethered cord syndrome (TCS) characterized by urination dysfunction has long been a worldwide clinical problem, of which clinical effects remains controversial.PurposeTo evaluate clinical effects of an innovative surgical method for treatment of TCS.Study DesignThis is a retrospective clinical study.Patient SampleThere were 15 patients included in this study.Outcome MeasuresThe visual analog scale (VAS) and the Japanese Orthopaedic Association (JOA) scores were evaluated. The incidence of complications after surgery was also analyzed.MethodsA total of 15 patients including 9 males and 6 females with TCS received the homogeneous spinal-shortening axial decompression (HSAD) from September 2011 to February 2015. The average age at the time of surgery was 38.1±17.7 years. The average postoperative follow-up period was 21.5±7.5 months. The VAS and JOA scores were used to evaluate clinical effects of the new operational procedure. In addition, the incidence of complications was also recorded and analyzed.ResultsThe VAS scores decreased from 3.93±2.52 to 1.80±1.21 at final follow-up after surgery with significant statistical difference (p=0.006). The JOA scores also significantly increased from 9.93±3.43 to 21.20±4.18 at the final follow-up (p<0.001). Fourteen cases (93.3%) with bladder dysfunction and 7 cases with sensory dysfunction of lower limbs(87.5%)had significant improvement postoperatively. The complications such as infection, pulmonary embolism, nerve injury, rod broken, etc were not observed during the follow-up period.ConclusionsThe operation of HSAD was an effective and safe surgical method for TCS, which can achieve direct decompression of the tethered spinal cord.



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