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Symptomatic retethering of the spinal cord in postoperative lipomyelomeningocele patients: a meta-analysis
- Source :
- Child's Nervous System. 32:121-126
- Publication Year :
- 2015
- Publisher :
- Springer Science and Business Media LLC, 2015.
-
Abstract
- Timing of surgical treatment for tethered cord syndrome due to a lipomyelomeningocele (LMM) has been controversial. The purpose of this study was to evaluate populations of patients treated surgically for LMM in a meta-analysis in order to better understand how outcomes differ based on follow-up time, symptomatology, and LMM classification.An extensive search on PubMed and Google Scholar was performed for LMM and surgical outcomes to identify case series of patients for inclusion in this analysis. Patients were sorted based upon symptomatology prior to surgery and Chapman's LMM classification, where possible. Deterioration rates were determined by symptomatic retethering of the spinal cord that led to repeat surgery.Of 608 (19 %) patients, 115 were included in the study experienced deterioration leading to repeat surgery. Symptomatic and asymptomatic patients did not experience significantly different rates of deterioration after surgical untethering. There was a significant positive linear correlation between follow-up time of studies and percentage of patients deteriorating with an increase of 3.3 % per year of follow-up. Transitional LMM had a significantly higher rate of deterioration compared to the caudal type along with the entire patient pool.Outcomes of primary surgical treatment in regard to late deterioration are not significantly affected by patient symptomatology. Patient deterioration increases linearly over time. Additional studies should be performed to adequately determine the natural history of asymptomatic patients that are treated conservatively for LMM.
- Subjects :
- 0301 basic medicine
medicine.medical_specialty
Meningomyelocele
animal structures
Neurosurgical Procedures
03 medical and health sciences
Postoperative Complications
0302 clinical medicine
medicine
Humans
Neural Tube Defects
Surgical treatment
Tethered Cord
business.industry
General Medicine
Spinal cord
Surgery
Treatment Outcome
medicine.anatomical_structure
Spinal Cord
Meta-analysis
Pediatrics, Perinatology and Child Health
030101 anatomy & morphology
Neurology (clinical)
Neurosurgery
business
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 14330350 and 02567040
- Volume :
- 32
- Database :
- OpenAIRE
- Journal :
- Child's Nervous System
- Accession number :
- edsair.doi.dedup.....e389ee5cafe3f1312e0c639dbdf6f1d1