Efficacy of small-incision untethering surgery on tethered cord syndrome in children

Abstract

Objective To explore the efficacy and safety of small-incision untethering surgery in the treatment of tethered cord syndrome (TCS) in children. Methods We retrospectively collected the clinical data of TCS patients who underwent merely untethering surgery at Department of Neurosurgery, Children′s Hospital, Zhejiang University School of Medicine from May 2015 to May 2018. A total of 72 cases were included and all required transection of merely terminal filament. Among them, there were 33 patients undergoing small-incision operation (small-incision group) and 39 undergoing traditional surgery (traditional group). Comparative analysis of intraoperative incision size, postoperative complications, length of stay and postoperative treatment effect were implemented in both groups. Results All 72 patients underwent surgery successfully. None of the children in the small incision group needed to have the incision extended. In small-incision and tradition groups, the length of the incision was (2.5±0.3)cm and (4.8±1.9)cm respectively, and the length of stay was (4.4±1.8)days and (6.7±2.6)days respectively. Both differences were statistically significant (P 0.05). At the end of follow-up, the total effective rate in traditional group (> 6-41 months) was 89.7% (35/39), while that in small-incision group (>6-27 months) was 93.9% (31/33). There was no statistically difference between them (P>0.05). Conclusion The small-incision untethering for children with TCS who need merely transection of terminal filament seems as effective as traditional large-incision surgery. It has the advantages of small trauma and short length of stay. Key words: Tethered cord syndrome; Child; Microsurgery; Minimally invasive