ADULT POSTREPAIR MYELOMENINGOCOELE AND TETHERED CORD SYNDROME - GOOD SURGICAL OUTCOME AFTER ABRUPT NEUROLOGICAL DECLINE

Citation
Ag. Filler et al., ADULT POSTREPAIR MYELOMENINGOCOELE AND TETHERED CORD SYNDROME - GOOD SURGICAL OUTCOME AFTER ABRUPT NEUROLOGICAL DECLINE, British journal of neurosurgery, 9(5), 1995, pp. 659-666
Citations number
21
Categorie Soggetti
Neurosciences,Surgery
ISSN journal
02688697
Volume
9
Issue
5
Year of publication
1995
Pages
659 - 666
Database
ISI
SICI code
0268-8697(1995)9:5<659:APMATC>2.0.ZU;2-Q
Abstract
Adults who have had repair of an open myelomeningocoele at birth are s usceptible to a variant of adult onset tethered cord syndrome (ATCS). Precipitous and profound loss of lower extremity motor function occurr ed in two postrepair adult patients, but was not seen in any of our 12 cases of adult tethered cord with any other aetiologies. Both postrep air ATCS patients made a good recovery after surgical release of the t ether. For the patients with other aetiologies, surgery yielded improv ement or recovery of urinary continence in 57%, relief from pain in 78 % and improved strength in 80%. Evidence of retethering was observed i n 25% of the operated patients at intervals ranging from 1 to 9 years postoperatively. We conclude that surgical release of tether can rever se incontinence in ATCS of any aetiology and that in the post-myelomen ingocoele repair patient, both dexamethasone and surgical intervention are helpful in reversing acute neurological deterioration.