Preprint Technical Note Version 1 Preserved in Portico This version is not peer-reviewed

New Spinal Shortening Technique for Tethered Cord Syndrome: A Technical Note

Version 1 : Received: 13 November 2023 / Approved: 14 November 2023 / Online: 14 November 2023 (11:36:20 CET)

A peer-reviewed article of this Preprint also exists.

Tanaka, M.; Sonawane, S.; Arataki, S.; Fujiwara, Y.; Taoka, T.; Uotani, K.; Oda, Y.; Shinohara, K. New Spinal Shortening Technique for Tethered Cord Syndrome: A Technical Note. Medicina 2024, 60, 20. Tanaka, M.; Sonawane, S.; Arataki, S.; Fujiwara, Y.; Taoka, T.; Uotani, K.; Oda, Y.; Shinohara, K. New Spinal Shortening Technique for Tethered Cord Syndrome: A Technical Note. Medicina 2024, 60, 20.

Abstract

Study design : Technical note. Objectives: To present a new spinal shortening technique for tethered cord syndrome. Background : Tethered cord syndrome (TCS) is a debilitating condition of progressive neurological decline. Surgical detethering for TCS is a gold standard. However, symptomatic retethering of TCS has been reported in 5%–50% of patients after initial release. To solve this problem, posterior spinal shortening osteotomy has been reported. This technique has risks of massive blood loss and neurological deterioration. The authors hereby report a new safe spinal shortening technique for tethered cord syndrome. Materials and Methods : A 31-year-old man with gait disturbance was referred to our hospital. After the delivery, he underwent surgical untethering of spinal cord in another hospital. He had hyperreflexia of Achilles tendon reflex and muscle weakness of bilateral legs (MMT 3-4). He also had urinary and bowel incontinence, and total sensory loss below L5.Anteroposterior lumbar radiogram indicates partial laminectomy of L3 and L4. Lumbar MRI showed retethering of spinal cord. Results: He underwent new spinal shortening technique for tethered cord syndrome under the guidance of O-arm navigation. First, from anterior approach disectomy from T12 to L3 was performed. Second, from posterior Ponte osteotomy was done from T12 to L3, shorten the spinal column 15 mm. The patient was successfully treated surgically. Postoperative lumbar MRI showed the tension of spinal cord was released. Manual muscle testing results and sensory function of the left leg had recovered almost fully on final follow-up at one year. Conclusions/Level of Evidence: Retethered spinal cord after initial untethering was difficult to treat. This new spinal shortening technique was effective and very safe technique to release the tension of spinal cord. Level V.

Keywords

Tethered cord syndrome; Navigation; Spinal shortening osteotomy

Subject

Medicine and Pharmacology, Surgery

Comments (0)

We encourage comments and feedback from a broad range of readers. See criteria for comments and our Diversity statement.

Leave a public comment
Send a private comment to the author(s)
* All users must log in before leaving a comment
Views 0
Downloads 0
Comments 0


×
Alerts
Notify me about updates to this article or when a peer-reviewed version is published.
We use cookies on our website to ensure you get the best experience.
Read more about our cookies here.