gms | German Medical Science

63rd Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Japanese Neurosurgical Society (JNS)

German Society of Neurosurgery (DGNC)

13 - 16 June 2012, Leipzig

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Detethering of a tethered cord in adult patients – an outcome analysis

Meeting Abstract

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  • A. Romagna - Neurochirurgische Klinik und Poliklinik, Klinikum der Ludwig-Maximilians-Universität München, Campus Grosshadern, München
  • B. Suchorska - Neurochirurgische Klinik und Poliklinik, Klinikum der Ludwig-Maximilians-Universität München, Campus Grosshadern, München
  • C. Schwartz - Neurochirurgische Klinik und Poliklinik, Klinikum der Ludwig-Maximilians-Universität München, Campus Grosshadern, München
  • J.C. Tonn - Neurochirurgische Klinik und Poliklinik, Klinikum der Ludwig-Maximilians-Universität München, Campus Grosshadern, München
  • S. Zausinger - Neurochirurgische Klinik und Poliklinik, Klinikum der Ludwig-Maximilians-Universität München, Campus Grosshadern, München

Deutsche Gesellschaft für Neurochirurgie. Japanische Gesellschaft für Neurochirurgie. 63. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Japanischen Gesellschaft für Neurochirurgie (JNS). Leipzig, 13.-16.06.2012. Düsseldorf: German Medical Science GMS Publishing House; 2012. DocP 100

doi: 10.3205/12dgnc487, urn:nbn:de:0183-12dgnc4876

Published: June 4, 2012

© 2012 Romagna et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.en). You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.

Outline

Text

Objective: The tethered spinal cord syndrome (TCS) is characterized by an attachment of the spinal cord down toward the tail end of the spine, comprising the danger of myelopathic symptoms due to persisting traction on the spinal cord. We retrospectively analyzed the outcome of adult patients with TCS with special regard on the influence of additional resection of accompanying intraspinal lipomas.

Methods: Medical records of 27 adult patients with congenital TCS undergoing microsurgical detethering with neurophysiological guidance were analyzed. Sixteen patients suffered from TCS with additional spinal lipoma and 11 patients suffered from TCS without a lipoma. The extent of lipoma resection was recorded. Outcome parameters included the pre- and postoperative status concerning pain, sensorimotor deficits and bladder control. Wilcoxon rank test was used for statistical analysis.

Results: In all patients complete untethering could be achieved. While urinary symptoms remained stable, all patients showed a non-significant tendency towards improvement of sensorimotor deficits. Both patients with or without spinal lipoma experienced a significant postoperative amelioration of back pain. Patients with lipoma also had significantly less radicular pain. Patients with a shorter history of pain (<1 year) showed a significantly improved chance of relief from back and radicular pain than patients with longer lasting complaints. The extent of lipoma resection had no significant impact on postoperative pain or neurological deficits.

Conclusions: Adult symptomatic patients with a tethered spinal cord profit from detethering, especially concerning relief of lower back and radicular pain. Complete removal of a concomitant spinal lipoma does not seem to be mandatory for achieving a satisfying result.