The effect of tethered cord release on scoliosis in myelomeningocele

To understand better the effects of detethering on scoliosis in persons wit h myelomeningocele, 21 patients with spinal dysraphism and scoliosis who ha d undergone a detethering procedure were retrospectively reviewed. Fourteen girls and seven boys were followed for an average of 5 years (range, 2-10) . Three patients had thoracic, 12 had lumbar, and six had sacral level myel omeningocele. Three patients (14%) had curves that improved, and six (29%) stabilized. Twelve patients (57%) progressed >10 degrees. Eighty-six percen t of patients with initial curves of >40 degrees and 100% of thoracic level patients went on to require spinal fusion. Eight complications occurred in six patients. Although patients with curves <40 degrees may have some impr ovement after a detethering procedure, those presenting with curves >40 deg rees or thoracic neurologic levels had no improvement in their scoliosis.