Li Hao,Fan Shuangshi,Su Jun,et al.Unilateral intervertebral space approach through small incision for the treatment of occult tethered cord syndrome in children[J].Journal of Clinical Pediatric Surgery,,20():1154-1158.[doi:10.12260/lcxewkzz.2021.12.010]
Unilateral intervertebral space approach through small incision for the treatment of occult tethered cord syndrome in children
- Keywords:
- Occult Tethered Cord Syndrome; Terminal Filum; Surgical Procedures; Operative; Treatment Outcome; Child
- CLC:
- R651.2;R726.511
- Abstract:
- Objective To explore the clinical effect of surgical treatment through small incision of occult tethered cord syndrome (OTCS) in children, and provide reference for the diagnosis and treatment of OTCS in children.Methods The clinical data of 28 children with OTCS treated by terminal filum disconnection through minimally invasive incision from November 2020 to April 2021 were analyzed retrospectively.In total, 21 males and 7 females with the age ranged from 2 years and 8 months to 11 years and 7 months, and the average age was 6.4±2.4 years.Preoperative and postoperative MRI of lumbosacral in supine and prone position, preoperative sensory evoked potentials of lower limbs, residual urine volume of bladder, and postoperative pathological results were collected.The improvement of postoperative symptoms of patients was followed up.Results All children underwent minimally invasive incision through the unilateral intervertebral space approach to disconnect the terminal filum and loosen the tethered.28 children were followed up for 3~6 months after discharge with no new onset of neurological symptoms.The overall remission rate of postoperative symptoms was 78% (22/28);the remission rate of urinary system symptoms was 72% (13/18);the remission rate of intestinal dysfunction was 92% (12/13);the remission rate of lower limb symptoms was 100% (2/2).Conclusion Minimally invasive incision terminal filum disconnection can improve the clinical symptoms of children with OTCS.Prone position MRI is an important examination method for children with suspected OTCS, and is worthy of promotion.
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Memo
收稿日期:2021-05-30。
基金项目:湖南省出生缺陷协同防治科技重大专项（编号：2019SK1010）
通讯作者:吴水华,Email:292454021@qq.com