Pediatric Neurosurgery
Efficacy of small-incision untethering surgery on tethered cord syndrome in children
Shen Zhipeng, Zeng Hanhai, Shi Wujie, Zhang Peiliang, Weng Jianbin, Pan Luping, Lin Chao, Wang Ning
Published 2019-12-28
Cite as Chin J Neurosurg, 2019,35(12): 1226-1230. DOI: 10.3760/cma.j.issn.1001-2346.2019.12.008
Abstract
ObjectiveTo explore the efficacy and safety of small-incision untethering surgery in the treatment of tethered cord syndrome (TCS) in children.
MethodsWe retrospectively collected the clinical data of TCS patients who underwent merely untethering surgery at Department of Neurosurgery, Children′s Hospital, Zhejiang University School of Medicine from May 2015 to May 2018. A total of 72 cases were included and all required transection of merely terminal filament. Among them, there were 33 patients undergoing small-incision operation (small-incision group) and 39 undergoing traditional surgery (traditional group). Comparative analysis of intraoperative incision size, postoperative complications, length of stay and postoperative treatment effect were implemented in both groups.
ResultsAll 72 patients underwent surgery successfully. None of the children in the small incision group needed to have the incision extended. In small-incision and tradition groups, the length of the incision was (2.5±0.3)cm and (4.8±1.9)cm respectively, and the length of stay was (4.4±1.8)days and (6.7±2.6)days respectively. Both differences were statistically significant (P<0.01). In traditional group, 5 cases (12.8%) had surgery-related complications including 2 cases of wound infection, 1 case of cerebrospinal fluid leakage and 2 cases of pain requiring medication. Only 1 case of pain (3.0%, 1/33) required medication in small-incision group. The effective rates in traditional and small-incision groups were 92.3% (36/39) and 93.9% (31/33) respectively at 6 months post surgery, and the difference was not statistically significant (P>0.05). At the end of follow-up, the total effective rate in traditional group (> 6-41 months) was 89.7% (35/39), while that in small-incision group (>6-27 months) was 93.9% (31/33). There was no statistically difference between them (P>0.05).
ConclusionThe small-incision untethering for children with TCS who need merely transection of terminal filament seems as effective as traditional large-incision surgery. It has the advantages of small trauma and short length of stay.
Key words:
Tethered cord syndrome; Child; Microsurgery; Minimally invasive
Contributor Information
Shen Zhipeng
Department of Neurosurgery, Children′s Hospital, Zhejiang University School of Medicine, Hangzhou 310000, China
Zeng Hanhai
Shi Wujie
Zhang Peiliang
Weng Jianbin
Pan Luping
Lin Chao
Wang Ning
